Vasarainen , H , Salman , J , Salminen , H , Valdagni , R , Pickles , T , Bangma , C , Roobol , M J & Rannikko , A 2015 , ' Predictive role of free prostate-specific antigen in a prospective active surveillance program (PRIAS) ' , World Journal of Urology , vol. 33 , no. 11 , pp. 1735-1740 . https://doi.org/10.1007/s00345-015-1542-3
Title: | Predictive role of free prostate-specific antigen in a prospective active surveillance program (PRIAS) |
Author: | Vasarainen, Hanna; Salman, Jolanda; Salminen, Heidi; Valdagni, Riccardo; Pickles, Tom; Bangma, Chris; Roobol, Monique J.; Rannikko, Antti |
Contributor organization: | Clinicum Department of Surgery Urologian yksikkö |
Date: | 2015-11 |
Language: | eng |
Number of pages: | 6 |
Belongs to series: | World Journal of Urology |
ISSN: | 0724-4983 |
DOI: | https://doi.org/10.1007/s00345-015-1542-3 |
URI: | http://hdl.handle.net/10138/158377 |
Abstract: | To evaluate the utility of percentage of free serum PSA (%fPSA) as a predictor of adverse rebiopsy findings, treatment change and radical prostatectomy (RP) findings in a prospective active surveillance (AS) trial. Patients enrolled in the global PRIAS study with baseline %fPSA available were included. Putative baseline predictors (e.g. PSA, %fPSA) of adverse rebiopsy findings were explored using logistic regression analysis. Association of variables with treatment change and RP findings over time were evaluated with Cox regression analysis. Active treatment-free survival was assessed with a Kaplan-Meier method. Of 3701 patients recruited to PRIAS, 939 had %fPSA measured at study entry. Four hundred and thirty-eight of them had %fPSA available after 1 year. Median follow-up was 17.2 months. First rebiopsy results were available for 595 patients and of those, 144 (24.2 %) had adverse findings. A total of 283 (30.1 %) patients discontinued surveillance, of those 181 (64.0 %) due to protocol-based reasons. Although median %fPSA values were significantly lower in patients who changed treatment, according to the multivariate regression analysis, initial %fPSA value was not predictive for treatment change or adverse rebiopsy findings. However, the probability of discontinuing AS was significantly lower in patients with "favourable" initial %fPSA characteristics and %fPSA during follow-up (initial %fPSA a parts per thousand yen15 and positive %fPSA velocity) compared to those with "adverse" %fPSA characteristics (initial %fPSA <15 and negative %fPSA velocity). Diagnostic %fPSA provides no additional prognostic value when compared to other predictors already in use in AS protocols. However, %fPSA velocity during surveillance may aid in predicting the probability for future treatment change. |
Subject: |
Prostate cancer
Active surveillance Prostate-specific antigen Free prostate-specific antigen CANCER DETECTION DOUBLING TIME GLEASON SCORE PSA KINETICS RISK MEN MANAGEMENT DENSITY AGE 3122 Cancers |
Peer reviewed: | Yes |
Usage restriction: | openAccess |
Self-archived version: | publishedVersion |
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