Propsa and the prostate health index as predictive markers for aggressiveness in low-risk prostate cancer—results from an international multicenter study

ABSTRACT BACKGROUND: One of the major challenges in prostate cancer (PCa) treatment is distinguishing insignificant PCa from those forms that need active treatment. We evaluated the impact

of PSA isoforms on risk stratification in patients with low-risk PCa as well as in active surveillance (AS) candidates who underwent radical prostatectomy. METHODS: A total of 112 patients

with biopsy confirmed Gleason score (GS) 6 PCa of four different international institutions were prospectively enrolled in the study. Blood withdrawal was performed the day before radical

prostatectomy. In addition, patients were classified according to the EAU and NCCN criteria for AS candidates. PSA, free PSA (fPSA) and proPSA were measured using dual monoclonal antibody

sandwich immunoassays. In addition, the Prostate Health Index (PHI=proPSA/fPSA × √PSA) was calculated. Final histology of the radical prostatectomy specimens was correlated to PSA, its

isoforms and PHI. RESULTS: Serum proPSA levels were significantly elevated in those patients with an upgrade in final histology (GS⩾7). In addition, higher proPSA levels were predictive for

extraprostatic extension (⩾pT3a) as well as for positive surgical margins. Interestingly, PHI had an even higher predictive power when compared with proPSA alone concerning GS upgrading,

extraprostatic extension and surgical margins in both the total and the AS patient group. CONCLUSION: We showed in a multicenter study that proPSA is a valuable biomarker to detect patients

with aggressive PCa in a cohort of GS 6 patients, who would benefit from active tumor therapy. Combining proPSA with the standard markers PSA and fPSA using PHI further increases the

predictive accuracy significantly. Moreover, our data support the use of PHI for monitoring PCa patients under AS. Access through your institution Buy or subscribe This is a preview of

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BASED BIOMARKERS FOR DETECTION OF CLINICALLY-SIGNIFICANT PROSTATE CANCER Article 10 June 2024 CLINICAL UTILITY OF A SERUM BIOMARKER PANEL IN DISTINGUISHING PROSTATE CANCER FROM BENIGN

PROSTATE HYPERPLASIA Article Open access 23 July 2021 PSA DENSITY IS COMPLEMENTARY TO PROSTATE MP-MRI PI-RADS SCORING SYSTEM FOR RISK STRATIFICATION OF CLINICALLY SIGNIFICANT PROSTATE CANCER

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Scholar  Download references ACKNOWLEDGEMENTS We thank Dr Gabriele Dobler for technical support. The study was funded by the Tiroler Krebshilfe (Grant to IH). AUTHOR CONTRIBUTIONS IH was

involved in planning and organizing the study, ethics, sample collection in Innsbruck, funding, manuscript and preparation of the revised manuscript. RP was involved in sample collection and

preparation in Innsbruck, manuscript. AP contributed towards the ethics, sample collection and preparation in Innsbruck, manuscript, preparation of the revised manuscript. WP was involved

in the laboratory analyses. ES was involved in the statistics and preparation of the revised manuscript. AP, EC and CL were involved in the sample collection in Bolzano. AL and EP was

involved in the sample collection in Vienna. DD was involved in the sample collection in Belgrad. WH, HK and JB contributed towards the general idea and supervision. AUTHOR INFORMATION

AUTHORS AND AFFILIATIONS * Department of Urology, Medical University Innsbruck, Innsbruck, Austria I Heidegger, H Klocker, R Pichler, E Steiner, W Horninger & J Bektic * Department of

Internal Medicine V, Hematology and Oncology, Medical University Innsbruck, Innsbruck, Austria A Pircher * Department of Laboratory and Chemical Medicine, Medical University Innsbruck,

Innsbruck, Austria W Prokop * Department of Urology, Hospital of Bolzano, Bolzano, Italy C Ladurner, E Comploj & A Pycha * Department of Urology, Hanusch Hospital Wien, Vienna, Austria A

Lunacek & E Plas * Department of Urology, Klinicki centar Srbije Beograd, Belgrade, Serbia D Djordjevic Authors * I Heidegger View author publications You can also search for this

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permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Heidegger, I., Klocker, H., Pichler, R. _et al._ ProPSA and the Prostate Health Index as predictive markers for aggressiveness in low-risk

prostate cancer—results from an international multicenter study. _Prostate Cancer Prostatic Dis_ 20, 271–275 (2017). https://doi.org/10.1038/pcan.2017.3 Download citation * Received: 20

October 2016 * Revised: 23 December 2016 * Accepted: 09 January 2017 * Published: 21 March 2017 * Issue Date: September 2017 * DOI: https://doi.org/10.1038/pcan.2017.3 SHARE THIS ARTICLE

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