Predicting Prostate Cancer Biochemical Recurrence Using a Panel of Serum Proteomic Biomarkers

Purpose: The pathological state of the prostate may be reflected by serum proteome in a man. We hypothesized that biomarkers are present in preoperative serum, which may be used to predict the probability of Biochemical Recurrence following radical prostatectomy.Materials and Methods: Mass spectrometry analysis was used to compare 52 men who experienced Biochemical Recurrence with 52 who remained Biochemical Recurrence-free for approximately 5 years after radical retropubic prostatectomy. A total of 30 matched pairs of recurrent and nonrecurrent serum samples were randomly selected as a training set for biomarker discovery and model development. Selected mass spectrometry peaks were combined with pre-radical retropubic prostatectomy prostate specific antigen in a multivariate algorithm to predict Recurrence. The algorithm was evaluated using the remaining 22 recurrent and 22 nonrecurrent subjects as test samples. Protein identities of the selected mass spectrometry peaks were investigated.Results: Two ser…

Complexed prostate-specific antigen for the diagnosis of Biochemical Recurrence after radical prostatectomy.

OBJECTIVES

To determine the validity of using complexed prostate-specific antigen (cPSA) levels for diagnosing Biochemical Recurrence after radical prostatectomy (RP).

PATIENTS AND METHODS

With linear regression modelling, we determined threshold cPSA levels for Biochemical Recurrence in patients after RP for clinically localized prostate cancer. We calculated sensitivity, specificity, predictive values, and likelihood ratio tests of each threshold for diagnosing Biochemical Recurrence using total PSA (tPSA) as the reference standard.

RESULTS

In the regression models, tPSA and cPSA were highly correlated (r = 0.99). For the diagnosis of Biochemical Recurrence, tPSA thresholds of 0.20 and 0.40 ng/mL corresponded to cPSA thresholds of 0.12 ng/mL (95% confidence interval 0.08–0.17) and 0.29 (0.22–0.28)  ng/mL, respectively. For the detection of Biochemical Recurrence, a cPSA threshold of 0.12 ng/mL had a sensitivity of 96%, specificity of 88%, positive predictive value of 89%, negative predictive value of 88%, positive likelihood ratio of 8, and negative likelihood ratio of 0.05; the respective values for a cPSA threshold of 0.29 ng/mL were 96%, 96%, 96%, 96%, 24 and 0.04.

CONCLUSIONS

cPSA has high validity for the diagnosis of Biochemical Recurrence after RP. Pending external validation, cPSA might be useful for Biochemical surveillance after RP.

risk of prostate cancer specific mortality following Biochemical Recurrence after radical prostatectomy

ContextThe natural history of Biochemical Recurrence after radical prostatectomy
can be long but variable. Better risk assessment models are needed to identify
men who are at high risk for prostate cancer death early and who may benefit
from aggressive salvage treatment and to identify men who are at low risk
for prostate cancer death and can be safely observed.ObjectivesTo define risk factors for prostate cancer death following radical prostatectomy
and to develop tables to risk stratify for prostate cancer–specific
survival.Design, Setting, and PatientsRetrospective cohort study of 379 men who had undergone radical prostatectomy
at an urban tertiary care hospital between 1982 and 2000 and who had a Biochemical
Recurrence and after Biochemical failure had at least 2 prostate-specific
antigen (PSA) values at least 3 months apart in order to calculate PSA doubling
time (PSADT). The mean (SD) follow-up after surgery was 10.3 (4.7) years and
median follow-up was 10 years (range, 1-20 years).Main Outcome MeasureProstate cancer–specific mortality.ResultsMedian survival had not been reached after 16 years of follow-up after
Biochemical Recurrence. Prostate-specific doubling time (<3.0 vs 3.0-8.9 vs 9.0-14.9 vs ≥15.0 months), pathological Gleason score (≤7 vs 8-10), and time from surgery to Biochemical Recurrence (≤3 vs >3 years) were all
significant risk factors for time to prostate-specific mortality. Using these
3 variables, tables were constructed to estimate the risk of prostate cancer–specific
survival at year 15 after Biochemical Recurrence.ConclusionClinical parameters (PSADT, pathological Gleason score, and time from
surgery to Biochemical Recurrence) can help risk stratify patients for prostate
cancer–specific mortality following Biochemical Recurrence after radical
prostatectomy. These preliminary findings may serve as useful guides to patients
and their physicians to identify patients at high risk for prostate cancer–specific
mortality following Biochemical Recurrence after radical prostatectomy to
enroll them in early aggressive treatment trials. In addition, these preliminary
findings highlight that survival in low-risk patients can be quite prolonged.

risk of prostate cancer specific mortality following Biochemical Recurrence after radical prostatectomy

ContextThe natural history of Biochemical Recurrence after radical prostatectomy
can be long but variable. Better risk assessment models are needed to identify
men who are at high risk for prostate cancer death early and who may benefit
from aggressive salvage treatment and to identify men who are at low risk
for prostate cancer death and can be safely observed.ObjectivesTo define risk factors for prostate cancer death following radical prostatectomy
and to develop tables to risk stratify for prostate cancer–specific
survival.Design, Setting, and PatientsRetrospective cohort study of 379 men who had undergone radical prostatectomy
at an urban tertiary care hospital between 1982 and 2000 and who had a Biochemical
Recurrence and after Biochemical failure had at least 2 prostate-specific
antigen (PSA) values at least 3 months apart in order to calculate PSA doubling
time (PSADT). The mean (SD) follow-up after surgery was 10.3 (4.7) years and
median follow-up was 10 years (range, 1-20 years).Main Outcome MeasureProstate cancer–specific mortality.ResultsMedian survival had not been reached after 16 years of follow-up after
Biochemical Recurrence. Prostate-specific doubling time (<3.0 vs 3.0-8.9 vs 9.0-14.9 vs ≥15.0 months), pathological Gleason score (≤7 vs 8-10), and time from surgery to Biochemical Recurrence (≤3 vs >3 years) were all
significant risk factors for time to prostate-specific mortality. Using these
3 variables, tables were constructed to estimate the risk of prostate cancer–specific
survival at year 15 after Biochemical Recurrence.ConclusionClinical parameters (PSADT, pathological Gleason score, and time from
surgery to Biochemical Recurrence) can help risk stratify patients for prostate
cancer–specific mortality following Biochemical Recurrence after radical
prostatectomy. These preliminary findings may serve as useful guides to patients
and their physicians to identify patients at high risk for prostate cancer–specific
mortality following Biochemical Recurrence after radical prostatectomy to
enroll them in early aggressive treatment trials. In addition, these preliminary
findings highlight that survival in low-risk patients can be quite prolonged.

Risk of prostate cancer-specific mortality following Biochemical Recurrence after radical prostatectomy.

ContextThe natural history of Biochemical Recurrence after radical prostatectomy
can be long but variable. Better risk assessment models are needed to identify
men who are at high risk for prostate cancer death early and who may benefit
from aggressive salvage treatment and to identify men who are at low risk
for prostate cancer death and can be safely observed.ObjectivesTo define risk factors for prostate cancer death following radical prostatectomy
and to develop tables to risk stratify for prostate cancer–specific
survival.Design, Setting, and PatientsRetrospective cohort study of 379 men who had undergone radical prostatectomy
at an urban tertiary care hospital between 1982 and 2000 and who had a Biochemical
Recurrence and after Biochemical failure had at least 2 prostate-specific
antigen (PSA) values at least 3 months apart in order to calculate PSA doubling
time (PSADT). The mean (SD) follow-up after surgery was 10.3 (4.7) years and
median follow-up was 10 years (range, 1-20 years).Main Outcome MeasureProstate cancer–specific mortality.ResultsMedian survival had not been reached after 16 years of follow-up after
Biochemical Recurrence. Prostate-specific doubling time (3 years) were all
significant risk factors for time to prostate-specific mortality. Using these
3 variables, tables were constructed to estimate the risk of prostate cancer–specific
survival at year 15 after Biochemical Recurrence.ConclusionClinical parameters (PSADT, pathological Gleason score, and time from
surgery to Biochemical Recurrence) can help risk stratify patients for prostate
cancer–specific mortality following Biochemical Recurrence after radical
prostatectomy. These preliminary findings may serve as useful guides to patients
and their physicians to identify patients at high risk for prostate cancer–specific
mortality following Biochemical Recurrence after radical prostatectomy to
enroll them in early aggressive treatment trials. In addition, these preliminary
findings highlight that survival in low-risk patients can be quite prolonged.

Predicting prostate cancer specific mortality following Biochemical Recurrence after radical prostatectomy

4546 Background: The natural history of Biochemical Recurrence (BCR) after radical prostatectomy (RP) can be long, but variable. Better predictive models are needed to identify men early who are at…

metformin does not affect risk of Biochemical Recurrence following radical prostatectomy results from the search database

Metformin does not affect risk of Biochemical Recurrence following radical prostatectomy: results from the SEARCH database