Preoperative %p2PSA and Prostate Health Index Predict Pathological Outcomes in Patients with Prostate Cancer Undergoing Radical Prostatectomy
Journal
Scientific Reports
Journal Volume
10
Journal Issue
1
Date Issued
2020
Author(s)
Cheng, Yung-Ting
Hung, Shih-Chun
Chiang, Chih-Hung
Abstract
To evaluate the predictive accuracy of the %p2PSA and prostate health index (PHI) in predicting aggressive pathological outcomes in patients with prostate cancer (PCa) undergoing radical prostatectomy (RP), we enrolled 91 patients with organ-confined PCa who were treated with robot-assisted RP. p2PSA levels and the PHI were investigated for their ability to predict pathological results. The %p2PSA and PHI were both significantly higher in patients with ?pT3 disease, high-risk disease, positive surgical margin, or seminal vesical invasion (SVI). In univariable analysis, p2PSA derivatives were significant predictors of the presence of ?pT3 disease, high-risk disease, positive surgical margin, and SVI. To predict adverse pathological outcomes at a sensitivity of 90%, p2PSA derivatives had higher specificity than standard PSA derivatives. In multivariable analysis, additional increases in the area under the receiver operating characteristic curve (AUC) were observed with the %p2PSA and PHI for ?pT3 disease, high-risk disease, and positive surgical margin (8.2% and 2.7%, 6.2% and 4.1%, and 8.6% and 5.4%, respectively). A PHI ?61.26 enhanced the predictive accuracy of the model for SVI by increasing the AUC from 0.624 to 0.819 (p = 0.009). The preoperative %p2PSA and PHI accurately predict adverse pathological results and are useful for decision-making. ? 2020, The Author(s).
SDGs
Other Subjects
prostate specific antigen; tumor marker; aged; human; male; metabolism; middle aged; preoperative period; procedures; prognosis; prospective study; prostate tumor; prostatectomy; receiver operating characteristic; treatment outcome; Aged; Biomarkers, Tumor; Humans; Male; Middle Aged; Preoperative Period; Prognosis; Prospective Studies; Prostate-Specific Antigen; Prostatectomy; Prostatic Neoplasms; ROC Curve; Treatment Outcome
Type
journal article