Editorial Comment on: Prostate-Specific Antigen Kinetics in Clinical Decision-Making During Active Surveillance for Early Prostate Cancer—A Review

2008 ◽  
Vol 54 (3) ◽  
pp. 514-515
Author(s):  
Roger Rittmaster
2008 ◽  
Vol 54 (3) ◽  
pp. 505-516 ◽  
Author(s):  
Roderick C.N. van den Bergh ◽  
Stijn Roemeling ◽  
Monique J. Roobol ◽  
Tineke Wolters ◽  
Fritz H. Schröder ◽  
...  

The Lancet ◽  
2003 ◽  
Vol 361 (9362) ◽  
pp. 1045-1053 ◽  
Author(s):  
Ashesh B Jani ◽  
Samuel Hellman

Author(s):  
Lieke JJ Klinkenberg ◽  
Eef GWM Lentjes ◽  
Arjen-Kars Boer

Background Prostate-specific antigen is the biochemical gold standard for the (early) detection and monitoring of prostate cancer. Interpretation of prostate-specific antigen is both dependent on the method and cut-off. The aim of this study was to examine the effect of method-specific differences and cut-off values in a national external quality assessment scheme (EQAS). Methods The Dutch EQAS for prostate-specific antigen comprised an annual distribution of 12 control materials. The results of two distributions were combined with the corresponding cut-off value. Differences between methods were quantified by simple linear regression based on the all laboratory trimmed mean. To assess the clinical consequence of method-specific differences and cut-off values, a clinical data-set of 1040 patients with an initial prostate-specific antigen measurement and concomitant conclusive prostate biopsy was retrospectively collected. Sensitivity and specificity for prostate cancer were calculated for all EQAS participants individually. Results In the Netherlands, seven different prostate-specific antigen methods are used. Interestingly, 67% of these laboratories apply age-specific cut-off values. Methods showed a maximal relative difference of 26%, which were not reflected in the cut-off values. The largest differences were caused by the type of cut-off, for example in the Roche group the cut-off value differed maximal 217%. Clinically, a fixed prostate-specific antigen cut-off has a higher sensitivity than an age-specific cut-off (mean 89% range 86–93% versus 79% range 63–95%, respectively). Conclusions This study shows that the differences in cut-off values exceed the method-specific differences. These results emphasize the need for (inter)national harmonization/standardization programmes including cut-off values to allow for laboratory-independent clinical decision-making.


2020 ◽  
Vol 1 (1) ◽  
pp. 30-38
Author(s):  
Renu S Eapen ◽  
Peter E Lonergan ◽  
Dominic Bagguley ◽  
Sean Ong ◽  
Ben Condon ◽  
...  

At every stage of the prostate cancer journey from screening and diagnosis to management of advanced disease, patients and clinicians face dilemmas and decisions that can impact long-term outcomes. Although traditional risk stratification in prostate cancer is based on serum prostate specific antigen, clinical stage and Gleason score, in recent years, biomarkers have been developed that may be useful in several clinical scenarios. Biomarkers that can accurately predict an individual patient’s risk, prognosis, and response to specific treatments could lead to improvements in decision-making and clinical care. Although there is evidence to support the use of biomarkers to guide management decisions, the optimal scenario in which to use them, how to interpret the results, and how to incorporate those results into clinical decision-making can be confusing. Nevertheless, in the era of personalized and precision medicine, it is important for clinicians to be aware of what tests are available, what clinical questions they seek to answer, and what limitations they have. This review focuses on the serum and urine biomarkers for the management of prostate cancer that have been under intense investigation in recent years.


2018 ◽  
Vol 100 (2) ◽  
pp. 146-154
Author(s):  
Angeles Sanchis-Bonet ◽  
Marta Barrionuevo-González ◽  
Ana Bajo-Chueca ◽  
Nelson Morales-Palacios ◽  
Manuel Sanchez-Chapado

2008 ◽  
Vol 180 (5) ◽  
pp. 1959-1963 ◽  
Author(s):  
Stacy Loeb ◽  
Daniel W. Chan ◽  
Lori Sokoll ◽  
Donghui Kan ◽  
Jack Maggiore ◽  
...  

Author(s):  
Irene Casanova-Salas ◽  
Alejandro Athie ◽  
Paul C. Boutros ◽  
Marzia Del Re ◽  
David T. Miyamoto ◽  
...  

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