Among men with low-grade prostate cancer on prostate biopsy, the 4Kscore to predict prostate cancer aggressiveness at prostatectomy.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 65-65
Author(s):  
Bruno Nahar ◽  
Sanoj Punnen ◽  
Stephen M Zappala ◽  
Daniel Sjoberg ◽  
Dipen Parekh
Keyword(s):  
Prostate Cancer ◽  
United States ◽  
Radical Prostatectomy ◽  
Prostate Biopsy ◽  
The United States ◽  
Low Grade ◽  
Surgical Specimen ◽  
Aggressive Prostate Cancer ◽  
Free Psa ◽  
Cancer Aggressiveness

65 Background: Most men diagnosed with prostate cancer in the United States have low-grade tumors. While many of these men are good candidates for active surveillance, a proportion will have a bad outcome due to the presence of a more aggressive prostate cancer that was missed on initial biopsy. A recent study confirmed the 4Kscore accurately predicts the likelihood of aggressive cancer on prostate biopsy. We analyzed if the 4Kscore could predict the presence of more significant cancer in men with low-grade tumors on the diagnostic biopsy. Methods: A recent prospective validation of the 4Kscore was conducted at 26 sites throughout the United States. We selected men who were found to have low-grade (Gleason 6) cancer on biopsy for this analysis. The 4Kscore calculates the risk of aggressive prostate cancer on prostate biopsy by a blood test that measures levels of four kallikrein biomarkers (total PSA, free PSA, intact PSA, and human kallikrein-2) plus age, DRE findings, and prior biopsy status. We investigated whether the 4Kscore was associated with more significant cancer among men found to have Gleason 6 cancer on prostate biopsy. We also looked at a subset of these men who underwent radical prostatectomy to see if the 4Kscore was associated with prostate cancer being upgraded in the surgical specimen. Results: Among the 1,312 men enrolled in this trial, 306 men were found to have Gleason 6 cancer on prostate biopsy. The 4Kscore was significantly associated with the number of positive cores (p=0.001) and the millimeters of cancer seen (p=0.0002), with higher 4Kscores relating to more extensive cancer present on biopsy. In the subpopulation of 51 men who underwent radical prostatectomy, the median 4Kscore was significantly higher among men who had an upgrade to Gleason 7 or higher [15% (8,25)] compared to men who did not experience an upgrade [7% (4,14)] (p=0.032) in their final pathology. Conclusions: Among men with Gleason 6 prostate cancer on biopsy, the 4Kscore was associated with the prostate cancer being upgraded in the surgical specimen at radical prostatectomy. The 4Kscore test may facilitate the selection of men who can be observed versus those who should undergo immediate treatment.

The 4Kscore to predict the grade and stage of prostate cancer in the radical prostatectomy specimen: Results from a multi-institutional prospective trial.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 69-69
Author(s):  
Bruno Nahar ◽  
Sanoj Punnen ◽  
Daniel Sjoberg ◽  
Stephen M Zappala ◽  
Dipen Parekh
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Validation Study ◽  
Prostate Biopsy ◽  
Prostate Gland ◽  
Prospective Trial ◽  
Digital Rectal Examination ◽  
Treatment Decision ◽  
The United States ◽  
Surgical Specimen

69 Background: A recent prospective validation study confirmed the 4Kscore accurately predicted aggressive prostate cancer on prostate biopsy. We investigated the association between the 4Kscore and pathologic grade and stage at radical prostatectomy, where the entire prostate gland is sampled. Methods: Prospective enrollment of 1,312 men who were referred for prostate biopsy for clinical suspicion of prostate cancer occurred at 26 sites throughout the United States from October 2013 to April 2014. We selected men who were found to have positive prostate cancer biopsies and elected to undergo radical prostatectomy. The 4Kscore is an algorithm that incorporates a panel of 4 Kallikreins (total PSA, free PSA, intact PSA and human kallikrein-2) in addition to age, digital rectal examination, and prior biopsy status. We assessed the concordance between the 4Kscore prior to biopsy and grade of prostate cancer at radical prostatectomy. 4Kscore test results were compared for those with and without non organ-confined tumors at surgery using the Wilcoxon rank-sum. Results: Among the 1,312 men who enrolled in this validation study, 144 were found to have prostate cancer and underwent radical prostatectomy. We saw a significant association between the 4Kscore and grade at surgery with higher scores relating to worse grade. For men with Gleason 6, 7, and 8 or higher cancers in the surgical specimen the median (IQR) 4Kscore was 7% (4, 12), 25% (12, 38), and 47% (24, 66) (p<0.0001).The median 4Kscore among men with non organ-confined cancer was significantly higher then men with cancers confined to the prostate ([36% (IQR 19,58)] vs. [19% (IQR 9, 35)], p=0.002). Conclusions: In a subset of men who underwent radical prostatectomy, the 4Kscore was significantly associated with pathological grade and extracapsular extension in the surgical specimen, with higher scores being linked to higher grade and more aggressive histology. The test can be beneficial to aid in treatment decision making for men who are contemplating observation of their cancer versus immediate treatment.

scholarly journals Prevalence of TMPRSS2-ERG Fusion Prostate Cancer among Men Undergoing Prostate Biopsy in the United States

2009 ◽  
Vol 15 (14) ◽  
pp. 4706-4711 ◽  
Author(s):  
Juan-Miguel Mosquera ◽  
Rohit Mehra ◽  
Meredith M. Regan ◽  
Sven Perner ◽  
Elizabeth M. Genega ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
United States ◽  
Prostate Biopsy ◽  
The United States

scholarly journals Cutting to the Core of the Issue: Emerging Strategies To Reduce Prostate Biopsy-Related Infections

2016 ◽  
Vol 54 (10) ◽  
pp. 2431-2435 ◽  
Author(s):  
Robin R. Chamberland
Keyword(s):  
Prostate Cancer ◽  
United States ◽  
Prostate Biopsy ◽  
Current Trend ◽  
The United States ◽  
Infectious Complications ◽  
Published Data ◽  
The Core ◽  
Link Type ◽  
Transrectal Prostate Biopsy

Over 1 million men undergo biopsy in the United States each year to evaluate for prostate cancer (S. Loeb, H. B. Carter, S. I. Berndt, W. Ricker, and E. M. Schaeffer, J Urol 186:1830–1834, 2011,http://dx.doi.org/10.1016/j.juro.2011.06.057). In recent years, there has been a rise in infectious complications related to these procedures. This review aims to provide an overview of the guidelines that direct transrectal prostate biopsy, to describe associated infection, and to evaluate the published data driving the current trend toward prebiopsy screening for resistant organisms.

scholarly journals Design and Simulation of Robotic Needle Guide for Transperineal Prostate Biopsy

2018 ◽  
Author(s):  
Hossein Dehghani ◽  
Shihao Zhang ◽  
Pankaj Kulkarni ◽  
Pradipta Biswas ◽  
Leslie Simms ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
United States ◽  
Prostate Biopsy ◽  
The United States ◽  
The Third ◽  
Transperineal Prostate Biopsy ◽  
The Us ◽  
Reproductive Gland

Prostate cancer is the third leading cause of cancer-related death for males in the United States [1]. Over three million Americans with prostate cancer were reported in 2016 [2] marking the prostate cancer as the most prevalent cancer among males in the US. In 2016, 180,890 new cases and 26,120 deaths were reported [1]. The prostate is a male reproductive gland located in the pelvis and surrounded by the rectum posteriorly and the bladder superiorly.

scholarly journals Use of high and very high dose radiotherapy after radical prostatectomy for prostate cancer in the United States

2018 ◽  
Vol 21 (4) ◽  
pp. 584-593 ◽  
Author(s):  
P. Alexidis ◽  
W. Guo ◽  
J. E. Bekelman ◽  
N. Vapiwala ◽  
P. E. Gabriel ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
United States ◽  
Radical Prostatectomy ◽  
The United States ◽  
High Dose ◽  
Very High
Sign in / Sign up

Export Citation Format

Share Document