Total and transition zone prostate volume and age: how do they affect the utility of PSA-based diagnostic parameters for early prostate cancer detection?

Djavan, Bob; Zlotta, Alexandre R.; Remzi, Mesut; Ghawidel, Keywan; Bursa, Bernd; Hruby, Stephan; Wolfram, Roswitha; Schulman, Claude; Marberger, Michael

doi:10.1016/s0090-4295(99)00329-5

Cited by 73 publications

(29 citation statements)

References 11 publications

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“…4,5 The clinical advantage of %fPSA, compared with tPSA, was demonstrated in the 4 -10 ng/mL tPSA range. 7,9,26,37,43 Data from this study on 975 patients with tPSA in the range of 4 -10 ng/mL confirmed the well known correlation. Both %fPSA and PSAD were significantly better than tPSA but performed equally regarding the AUC (0.731 vs. 0.744, respectively) and the cut-off levels at 90% and 95% sensitivity (39% vs. 36% and 20% vs. 25% specificity).…”

Section: Discussionsupporting

confidence: 79%

“…The PSAD of the transition zone (PSA-TZ) is another parameter and may show a further improvement in specificity compared with PSAD. 25,26,53 However, in the current study, we did not estimate PSA-TZ; because, in patients with small glands, in which this zone often is not enlarged markedly, the transition zone is more difficult to measure reliably. In contrast, Gohji et al 54 found in Japanese men that PSA-TZ could not offer additional information that was useful in the detection of PCa, although PSAD does offer such information.…”

Section: Discussionmentioning

confidence: 78%

“…All studies with Ն 500 patients and available data on men with tPSA in the 4 -10 ng/mL range demonstrated a similar performance of PSAD and %fPSA. 16,17,26,30,31 Thus, if PSAD does not perform better than %fPSA, then it cannot replace %fPSA, although it may be used as additional tool for %fPSA to detect PCa. The opportunity to perform an (uncomfortable) TRUS and calculating the PSAD, therefore, should be used especially in patients with lower tPSA concentrations, in whom the %fPSA cannot help to decide on a biopsy.…”

Section: Discussionmentioning

confidence: 99%

“…16,17,[22][23][24][25][26][27][28][29][30][31][32] Although most studies showed an advantage of using PSAD compared with PSA alone, only a few studies could demonstrate further a better performance of PSAD compared with %fPSA. [32][33][34] Two of those studies included relatively small numbers of patients (n ϭ 43 patients and n ϭ 105 patients).…”

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confidence: 99%

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The ratio of prostate‐specific antigen (PSA) to prostate volume (PSA density) as a parameter to improve the detection of prostate carcinoma in PSA values in the range of < 4 ng/mL

Stephan

Stroebel

Heinau

et al. 2005

Cancer

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Nowadays, there is a strong interest in carbon nanotubes (CNTs) since these nanostructured materials have large potential applications in different technological fields. In this work, a very simple approach for synthesizing CNTs in mild conditions has been developed and investigated. In particular, the nanotubes have been obtained by thermal defluorination of poly(tetrafluoroethylene) (PTFE) by Si, which also acts as an inorganic catalyst for the CNT growth. Fine powders of PTFE and Si were homogeneously mixed together and then compacted by cold pressing. The obtained composite pills were placed into a quartz tube furnace at 650°C, and a vacuum was applied to remove the gaseous by‐product (SiF4). The obtained pyrolysis product consisted of CNTs, wrapping the surface of silicon grains. CNTs have been characterized by scanning electron microscopy, Raman spectroscopy, and large angle x‐ray powder diffraction. © 2012 Wiley Periodicals, Inc. Adv Polym Techn 31: 246–251, 2012; View this article online at wileyonlinelibrary.com. DOI 10.1002/adv.21267

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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The ratio of prostate‐specific antigen (PSA) to prostate volume (PSA density) as a parameter to improve the detection of prostate carcinoma in PSA values in the range of < 4 ng/mL

Stephan

Stroebel

Heinau

et al. 2005

Cancer

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“…[8][9][10] However, almost all reports have concentrated on populations within the PSA 'grey zone' (PSA 2.0-10.0 ng ml 21 ). 8,11,12 Originally, a Western population was used to define the PSA 'grey zone'. It is well known that Asian men have much lower incidences of PCa compared to other races.…”

Section: Introductionmentioning

confidence: 99%

Prostate volume as an independent predictor of prostate cancer in men with PSA of 10–50 ng ml−1

Tang¹,

Jin²,

Uhlman³

et al. 2013

Asian J Androl

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Prostate volume (PV) has been shown to be associated with prostate cancer (PCa) detection rates in men with a prostate-specific antigen (PSA) in the 'grey zone' (2.0-10.0 ng ml 21 ). However, the PSA 'grey zone' in Asian men should be higher because the incidence of PCa in Asian men is relatively low. Therefore, we evaluated the association between PV and PCa detection rates in men with PSAs measuring 10-50 ng ml 21 . Men who underwent a 13-core prostatic biopsy with PV documentation participated in the study. A multivariate stepwise regression was used to evaluate whether the PV at time of prostate biopsy could predict the risk of PCa. The rates of PCa among men in different PSA ranges, stratified by PV medians (,60 and o60 ml), were calculated. There were 261 men included in the final analysis. PV was the strongest predictor of PCa risk (odds ratio, 0.02; P,0.001) compared to other variables. The PCa rates in men with PVs measuring ,60 and o60 ml in the 10-19.9 ng ml 21 PSA group were 40.6% and 15.1%, respectively, while the rates for men with PSAs measuring 20-50 ng ml 21 were 65.1% and 26.8%. PV is an independent predictor of PCa in men with PSA measuring 10-50 ng ml 21 . In clinical practice, particularly for those countries with lower incidences of PCa, PV should be considered when counselling patients with PSAs measuring 10-50 ng ml 21 regarding their PCa risks.

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Techniques and predictive models to improve prostate cancer detection

Herman

Dorsey

John

et al. 2009

Cancer

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The use of prostate-specific antigen (PSA) as a screening test remains controversial. There have been several attempts to refine PSA measurements to improve its predictive value. These modifications, including PSA density, PSA kinetics, and the measurement of PSA isoforms, have met with limited success. Therefore, complex statistical and computational models have been created to assess an individual's risk of prostate cancer more accurately. In this review, the authors examined the methods used to modify PSA as well as various predictive models used in prostate cancer detection. They described the mathematical underpinnings of these techniques along with their intrinsic strengths and weaknesses, and they assessed the accuracy of these methods, which have been shown to be better than physicians' judgment at predicting a man's risk of cancer. Without understanding the design and limitations of these methods, they can be applied inappropriately, leading to incorrect conclusions. These models are important components in counseling patients on their risk of prostate cancer and also help in the design of clinical trials by stratifying patients into different risk categories. Thus, it is incumbent on both clinicians and researchers to become familiar with these tools. Despite intensive work over the last several decades, prostate cancer continues to be the most common cancer in men and their second leading cause of cancer death. In 2008, it is estimated that 186,320 men received a new diagnosis of this disease, and nearly 29,000 died from it.1 However, there is no universal agreement on screening for prostate cancer. The American Urological Association and the American Cancer Society both recommend using a combination of digital rectal examination (DRE) and serum prostatespecific antigen (PSA) level to screen low-risk white men starting at age 50 years and to screen high-risk populations (including African Americans) starting at age 40 years. Much of the dilemma has to do with limitations of the PSA test itself, which has poor sensitivity and specificity. Various attempts to improve the predictive capacity of PSA likewise have met with only partial success. Because of these deficiencies, statistical and computational models have been created to more accurately predict a patient's risk of prostate cancer at biopsy. This, in turn, helps patients make a more informed decision concerning the choice to proceed with biopsy, a decision that should not be made lightly given the costs involved, the possibility of complications, and the chance of diagnosing clinically insignificant cancer. In this review, we provide a brief summary of PSA and its permutations and examine the methods that generate the predictive models as well as their inherent strengths and weaknesses.Overview of PSA and PSA-specific antigen modifications Catalona et al initially explored the use of PSA as a screening tool. In 2 large studies of healthy men aged !50 years, a higher screening PSA level was correlated with a greater likelihood of cancer. 5,6 Furth...

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Total and transition zone prostate volume and age: how do they affect the utility of PSA-based diagnostic parameters for early prostate cancer detection?

Cited by 73 publications

References 11 publications

The ratio of prostate‐specific antigen (PSA) to prostate volume (PSA density) as a parameter to improve the detection of prostate carcinoma in PSA values in the range of < 4 ng/mL

The ratio of prostate‐specific antigen (PSA) to prostate volume (PSA density) as a parameter to improve the detection of prostate carcinoma in PSA values in the range of < 4 ng/mL

Prostate volume as an independent predictor of prostate cancer in men with PSA of 10–50 ng ml−1

Techniques and predictive models to improve prostate cancer detection

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