Work

Mp39-11 Baseline Psa Before Age 60 as a Predictor of Important Prostate Cancer Diagnosis and Prostate Cancer-specific Mortality in the Intervention Arm of the Prostate, Lung, Colorectal and Ovarian Trial

Year: 2016

Type: article

Abstract: RESULTS: The meta-analysis included data from 1271 men with PSA 10-25 ng / ml of whom 316 were diagnosed with high-grade cancer (Gleason score!7) and 37% had positive digital rectal examination.Base model AUCs ranged from 0.61 to 0.74, with an overall meta-analytic estimate of 0.68 (95% CI 0.65, 0.72).In contrast, AUCs from the kallikrein panel ranged between between 0.78 to 0.89, with a meta-analytic estimate of 0.84 (95% CI 0.81, 0.86).The increment in AUC was no smaller than 0.09 in the any cohort.Focusing on the cohorts with contemporary biopsy and grading approaches, use of the panel at a typical cut-point of 7.5% would reduce the number of biopsies by 173 per 1000 men and delay the diagnosis of 6.5 high grade cancers.The risk of high-grade cancer in men deemed to be at low risk would be less than 4%, equivalent risk to a 70 year old with a PSA of 2 ng/ mL.CONCLUSIONS: The kallikrein panel retains its excellent discrimination for high grade prostate cancer in men with high PSA (10-25 ng / mL).Use of the panel in this population reduces biopsy rates without missing an undue number of high-grade tumors.

Source: The Journal of Urology

DOI: 10.1016/j.juro.2016.02.136