The impact of prostate‐specific antigen level at diagnosis on the relative survival of 28,531 men with localized carcinoma of the prostate

Sandblom, Gabriel; Ladjevardi, Sam; Garmo, Hans; Varenhorst, Eberhard

doi:10.1002/cncr.23235

Cited by 32 publications

(22 citation statements)

References 18 publications

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“…Interestingly, though men in both the intermediate and highest glucose subgroups had poorer PCa outcomes. These findings may have important clinical implications for PCa detection and treatment, particularly among men with high glucose and low PSA levels, as previous evidence have shown that low PSA level is also concomitant with poorer PCa survival [61]. Overall, our findings further support a potential role for the lipid and glucose metabolism in prostate carcinogenesis.…”

Section: Resultssupporting

confidence: 83%

“…This finding may be partly due to the fact that men with PSA <4 μg/L are not likely to be biopsied and may therefore be diagnosed in the symptomatic stage when the cancer is more aggressive or advanced. These results are also in line with other studies indicating that men with low-PSA producing cancers tend to develop very poorly differentiated or highly tumorigenic castration-resistant PCa cells [59][60][61].…”

Section: Glucosesupporting

confidence: 92%

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Association between baseline serum glucose, triglycerides and total cholesterol, and prostate cancer risk categories

et al. 2016

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Lifestyle‐related risk factors such as hyperglycemia and dyslipidemia have been associated with several cancers. However, studies exploring their link with prostate cancer (PCa) clinicopathological characteristics are sparse and inconclusive. Here, we investigated the associations between serum metabolic markers and PCa clinicopathological characteristics. The study comprised 14,294 men from the Swedish Apolipoprotein MOrtality RISk (AMORIS) cohort who were diagnosed with PCa between 1996 and 2011. Univariate and multivariable logistic regression were used to investigate the relation between glucose, triglycerides and total cholesterol and PCa risk categories, PSA, Gleason score, and T‐stage. Mean age at time of PCa diagnosis was 69 years. Men with glucose levels >6.9 mmol/L tend to have PSA<4 μg/L, while those with glucose levels of 5.6–6.9 mmol/L had a greater odds of PSA>20 μg/L compared to PSA 4.0–9.9 μg/L. Hypertriglyceridemia was also positively associated with PSA>20 μg/L. Hyperglycemic men had a greater odds of intermediate‐ and high‐grade PCa and advanced stage or metastatic PCa. Similarly, hypertriglyceridemia was positively associated with high‐grade PCa. There was also a trend toward an increased odds of intermediate risk localized PCa and advanced stage PCa among men with hypertriglyceridemia. Total cholesterol did not have any statistically significant association with any of the outcomes studied. Our findings suggest that high serum levels of glucose and triglycerides may influence PCa aggressiveness and severity. Further investigation on the role of markers of glucose and lipid metabolism in influencing PCa aggressiveness and severity is needed as this may help define important targets for intervention.

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Section: Resultssupporting

confidence: 83%

Section: Glucosesupporting

confidence: 92%

Association between baseline serum glucose, triglycerides and total cholesterol, and prostate cancer risk categories

et al. 2016

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“…Second, a declining PSA level was associated with a significantly increased risk of PCSM in the present cohort. This correlation between low serum PSA levels and high‐grade prostate cancer has been shown in other studies [18,27,28], and may reflect the decrease in PSA production due to hypogonadism [29] or from dedifferentiated high‐grade prostate cancer cells [30]. The biological mechanism to explain this later phenomenon remains unclear.…”

Section: Discussionsupporting

confidence: 62%

Early detection of high‐grade prostate cancer using digital rectal examination (DRE) in men with a prostate‐specific antigen level of <2.5 ng/mL and the risk of death

Hattangadi¹,

Chen

D’Amico

2012

BJU International

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Study Type – Prognosis (inception cohort) Level of Evidence 2a What's known on the subject? and What does the study add? There is little data on the utility of digital rectal examination (DRE) as a diagnostic tool in the era of prostate‐specific antigen (PSA) testing. Using a population‐based database, we found that detection of prostate cancer while still localized among men with high‐grade PSA‐occult disease may result in survival benefit. OBJECTIVE To determine whether detection of high‐grade prostate cancer while still clinically localised on digital rectal examination (DRE) can improve survival in men with a normal prostate‐specific antigen (PSA) level. PATIENTS AND METHODS From the Surveillance, Epidemiology and End Results database, 166 104 men with prostate cancer diagnosed between 2004 and 2007 were identified. Logistic regression was used to identify factors associated with the occurrence of palpable, PSA‐occult (PSA level of <2.5 ng/mL), Gleason score 8–10 prostate cancer. Fine and Gray's and Cox multivariable regressions were used to analyse whether demographic, treatment, and clinicopathological factors were associated with the risk of prostate cancer‐specific mortality (PCSM) and all‐cause mortality (ACM), respectively. RESULTS Both increasing age (adjusted odds ratio [aOR] 1.02, 95% confidence interval (CI) 1.01–1.03; P < 0.001) and White race (aOR 1.26, 95% CI 1.03–1.54; P= 0.027) were associated with palpable, Gleason 8–10 prostate cancer. Of 166 104 men, 685 (0.4%) had this subset of prostate cancer. Significant factors associated with risk of PCSM included PSA level (adjusted hazard ratio [aHR] 0.71, 95% CI 0.51–0.99; P= 0.04), higher Gleason score (aHR 2.20, 95% CI 1.25–3.87; P= 0.006), and T3–T4 vs T2 disease (aHR 3.11, 95% CI 1.79–5.41; P < 0.001). Significant factors associated with risk of ACM included age (aHR 1.03, 95% CI 1.01–1.06; P= 0.006), higher Gleason score (aHR 2.05, 95% CI 1.36–3.09; P < 0.001), and T3–T4 vs T2 disease (aHR 2.11, 95% CI 1.38–3.25, P < 0.001) CONCLUSIONS Clinically localised disease on DRE among men with PSA‐occult high‐grade prostate cancer was associated with improved PCSM and ACM, suggesting that DRE in this cohort (older age and White race) may have the potential to improve survival.

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“…6 Nevertheless, some PCa patients with poor prognoses have a low PSA level. 7,8 The currently available clinicalpathological features, such as the Gleason grade group, clinical and pathological stage and surgical margin, 9,10 are unable to provide accurate predictions for biochemical recurrence. [11][12][13] Thus, it is crucial to develop an accurate prognostic signature to predict the recurrence risk for PCa patients after radical prostatectomy.…”

Section: Introductionmentioning

confidence: 99%

A qualitative transcriptional signature for predicting the biochemical recurrence risk of prostate cancer patients after radical prostatectomy

Huang

Zhang

et al. 2020

The Prostate

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Background The qualitative transcriptional characteristics, the within‐sample relative expression orderings (REOs) of genes, are highly robust against batch effects and sample quality variations. Hence, we develop a qualitative transcriptional signature based on REOs to predict the biochemical recurrence risk of prostate cancer (PCa) patients after radical prostatectomy. Methods Gene pairs with REOs significantly correlated with the biochemical recurrence‐free survival (BFS) were identified from 131 PCa samples in the training data set. From these gene pairs, we selected a qualitative transcriptional signature based on the within‐sample REOs of gene pairs which could predict the recurrence risk of PCa patients after radical prostatectomy. Results A signature consisting of 74 gene pairs, named 74‐GPS, was developed for predicting the recurrence risk of PCa patients after radical prostatectomy based on the majority voting rule that a sample was assigned as high risk when at least 37 gene pairs of the 74‐GPS voted for high risk; otherwise, low risk. The signature was validated in six independent datasets produced by different platforms. In each of the validation datasets, the Kaplan‐Meier survival analysis showed that the average BFS of the low‐risk group was significantly better than that of the high‐risk group. Analyses of multiomics data of PCa samples from TCGA suggested that both the epigenomic and genomic alternations could cause the reproducible transcriptional differences between the two different prognostic groups. Conclusions The proposed qualitative transcriptional signature can robustly stratify PCa patients after radical prostatectomy into two groups with different recurrence risk and distinct multiomics characteristics. Hence, 74‐GPS may serve as a helpful tool for guiding the management of PCa patients with radical prostatectomy at the individual level.

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The impact of prostate‐specific antigen level at diagnosis on the relative survival of 28,531 men with localized carcinoma of the prostate

Cited by 32 publications

References 18 publications

Association between baseline serum glucose, triglycerides and total cholesterol, and prostate cancer risk categories

Association between baseline serum glucose, triglycerides and total cholesterol, and prostate cancer risk categories

Early detection of high‐grade prostate cancer using digital rectal examination (DRE) in men with a prostate‐specific antigen level of <2.5 ng/mL and the risk of death

A qualitative transcriptional signature for predicting the biochemical recurrence risk of prostate cancer patients after radical prostatectomy

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