Longitudinal modeling of ultrasensitive and traditional prostate-specific antigen and prediction of biochemical recurrence after radical prostatectomy

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http://hdl.handle.net/10138/169639

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Laajala , T D , Seikkula , H , Sadat , F S , Mirtti , T , Bostrom , P J & Elo , L L 2016 , ' Longitudinal modeling of ultrasensitive and traditional prostate-specific antigen and prediction of biochemical recurrence after radical prostatectomy ' Scientific Reports , vol. 6 , 36161 . DOI: 10.1038/srep36161

Title: Longitudinal modeling of ultrasensitive and traditional prostate-specific antigen and prediction of biochemical recurrence after radical prostatectomy
Author: Laajala, Teemu D.; Seikkula, Heikki; Sadat, Fatemeh Seyednasrollah; Mirtti, Tuomas; Bostrom, Peter J.; Elo, Laura L.
Contributor: University of Helsinki, Institute for Molecular Medicine Finland
Date: 2016-11-02
Language: eng
Number of pages: 10
Belongs to series: Scientific Reports
ISSN: 2045-2322
URI: http://hdl.handle.net/10138/169639
Abstract: Ultrasensitive prostate-specific antigen (u-PSA) remains controversial for follow-up after radical prostatectomy (RP). The aim of this study was to model PSA doubling times (PSADT) for predicting biochemical recurrence (BCR) and to capture possible discrepancies between u-PSA and traditional PSA (t-PSA) by utilizing advanced statistical modeling. 555 RP patients without neoadjuvant/adjuvant androgen deprivation from the Turku University Hospital were included in the study. BCR was defined as two consecutive PSA values > 0.2 ng/mL and the PSA measurements were log(2)-transformed. One third of the data was reserved for independent validation. Models were first fitted to the post-surgery PSA measurements using cross-validation. Major trends were then captured using linear mixed-effect models and a predictive generalized linear model effectively identified early trends connected to BCR. The model generalized for BCR prediction to the validation set with ROC-AUC of 83.6% and 95.1% for the 1 and 3 year follow-up censoring, respectively. A web-based tool was developed to facilitate its use. Longitudinal trends of u-PSA did not display major discrepancies from those of t-PSA. The results support that u-PSA provides useful information for predicting BCR after RP. This can be beneficial to avoid unnecessary adjuvant treatments or to start them earlier for selected patients.
Subject: RETROPUBIC PROSTATECTOMY
DOUBLING TIMES
CANCER
RELAPSE
RISK
PSA
ADENOCARCINOMA
IMMUNOASSAY
DIAGNOSIS
DATABASE
3111 Biomedicine
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