Range PSA Research Articles

MP30-01 AGE AND RACE ADJUSTED PROSTATE SPECIFIC ANTIGEN VALUES IN MEN WHO PRESENTED TO A SINGLE URBAN TERTIARY HEALTH CARE CENTER: A 25 YEAR EXPERIENCE

You have accessJournal of UrologyProstate Cancer: Detection & Screening III (MP30)1 Sep 2021MP30-01 AGE AND RACE ADJUSTED PROSTATE SPECIFIC ANTIGEN VALUES IN MEN WHO PRESENTED TO A SINGLE URBAN TERTIARY HEALTH CARE CENTER: A 25 YEAR EXPERIENCE Marcus Jamil, Deepansh Dalela, Patrick Etta, Brett Friedman, Jacob Keeley, Sohrab Arora, Nicholas Corsi, Akshay Sood, James Peabody, Craig Rogers, and Firas Abdollah Marcus JamilMarcus Jamil More articles by this author , Deepansh DalelaDeepansh Dalela More articles by this author , Patrick EttaPatrick Etta More articles by this author , Brett FriedmanBrett Friedman More articles by this author , Jacob KeeleyJacob Keeley More articles by this author , Sohrab AroraSohrab Arora More articles by this author , Nicholas CorsiNicholas Corsi More articles by this author , Akshay SoodAkshay Sood More articles by this author , James PeabodyJames Peabody More articles by this author , Craig RogersCraig Rogers More articles by this author , and Firas AbdollahFiras Abdollah More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002027.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Age adjusted Prostate-Specific Antigen (aaPSA) reference ranges are used to improve the specificity and sensitivity of PSA testing due to the inherent variability and progressive rise in PSA values as men of different races age. Although previous investigations have described the impact age and race have on “normal” range PSA, many of these investigations were of small sample size and over a short period of time. We sought to reinvestigate the age adjusted reference range for PSAs in men in a minority enriched community. METHODS: Henry Ford Health System is a large, racially diverse, integrated healthcare system in Southeast Michigan which was one of the first health care systems to utilize the electronic medical record. Over the study period (1995-2019), men aged 45 years or older and who self-identified as African American (AA), White (W) or other (O) and underwent PSA testing were included in the study. Men were further stratified into age categories, 45-50, 50-60, 61-70, 71-80 and >80 years. PSA values following a diagnosis of PCa were excluded. RESULTS: In all, 139,936 (W:99,873, AA:34,334 and O:5729) patients underwent at least one PSA test during the study. A total of 813,434 PSAs were completed, 5.4 (IQR: 2.0-7.0) PSAs were performed for each patient and 1.2 PSAs per year per patient. The median PSA increased with each successive age group, Figure 1. The screening sensitivity for AA between the ages of 50-60 and 60-70 was 91% and 92% respectively, compared to 77% and 82%, respectively for W counterparts when using a PSA cut off of 4. The specificity was 84% and 75% for AA between the ages of 50-60 and 60-70, respectively, compared to 88% and 82%, respectively for W counterparts, Table 1. CONCLUSIONS: AAPSA values varied between age groups and races and were less when compared to historical cohorts. A PSA cutoff of 4 may also not provide AA men with the same screening benefit as W men. This information may provide clinicians with valuable PSA reference ranges when caring for patients of different racial and age profiles. Source of Funding: na © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e499-e499 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Marcus Jamil More articles by this author Deepansh Dalela More articles by this author Patrick Etta More articles by this author Brett Friedman More articles by this author Jacob Keeley More articles by this author Sohrab Arora More articles by this author Nicholas Corsi More articles by this author Akshay Sood More articles by this author James Peabody More articles by this author Craig Rogers More articles by this author Firas Abdollah More articles by this author Expand All Advertisement Loading ...

MP05-14 THE DIAGNOSTIC PATHWAY OF PROSTATE CANCER IN THE MRI ERA INCLUDING RISK STRATIFICATION: APPLYING THE ROTTERDAM PROSTATE CANCER RISK CALCULATOR TO THE PRECISION TRIAL DATA

You have accessJournal of UrologyProstate Cancer: Detection & Screening I (MP05)1 Sep 2021MP05-14 THE DIAGNOSTIC PATHWAY OF PROSTATE CANCER IN THE MRI ERA INCLUDING RISK STRATIFICATION: APPLYING THE ROTTERDAM PROSTATE CANCER RISK CALCULATOR TO THE PRECISION TRIAL DATA Sebastiaan Remmers, Veeru Kasivisvanathan, Caroline Moore, Monique Roobol, and Ivo de Vos Sebastiaan RemmersSebastiaan Remmers More articles by this author , Veeru KasivisvanathanVeeru Kasivisvanathan More articles by this author , Caroline MooreCaroline Moore More articles by this author , Monique RoobolMonique Roobol More articles by this author , and Ivo de VosIvo de Vos More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001972.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The multiple externally validated Rotterdam Prostate Cancer Risk Calculator (RPCRC and RPCRC- MRI) can be used as upfront risk stratification in the diagnostic pathway of prostate cancer (PC) and has shown to reduce the number of systematic biopsies (SBx), MRIs, and/or targeted biopsies (TBx) with good discrimination. Calibration issues can be solved by an intercept adaption, although calibration alone to correct for differences between the a priori risk in a contemporary clinical cohort may not suffice and also thresholds for referral need to be investigated. We retrospectively assessed the effect of upfront use of the RPCRC (developed in screening cohort) and RPCRC-MRI (developed in clinical cohort) in men all biopsy naïve with elevated risk solely on the basis of an elevated PSA level and normal DRE in the PRECISION trial [ref1]. METHODS: We recalibrated the models and assessed the performance of the RPCRC and RPCRC-MRI by discrimination, calibration and clinical utility. Originally risk thresholds for biopsy were at least 20% for any PC and 4% for clinically significant (c)PC (defined as Grade Group ≥2). RESULTS: In the TRUS arm of the PRECISION trial (i.e, all men SBx), the performance of the RPCRC was good (Fig), but stressed the importance of recalibration. Net benefit (NB) was observed from a recalibrated probability of 29% any PC and 10% cPC compared to biopsy all men. Without recalibration, the median (IQR) probability of men with cPC was 9.2 (5.4-20.9), but after recalibration this was 29.2 (19.0-51.9). With the threshold of 20% any PC or 10% cPC, 27% of all SBx could be avoided missing 5 cases of cPC (2xGG2, 2xGG3, 1xGG4; range PSA 4.2-6.9, PSA density 0.06-0.09) in line with previously reported [ref2], OR = 2.1 (95% CI 0.42-11.6), p=.3. In the MRI arm, the RPCRC without recalibration could have avoided 35% of all MRIs which is similar as previously reported [ref 2]. Recalibration of the RPCRC-MRI was not a necessity. For the men with a positive MRI, the original RPCRC-MRI with a threshold of 20% or 4% csPCa could lead to an reduction of 8% of all TBx missing 1 GG2 tumor. CONCLUSIONS: In conclusion, assessing the a priori risk is crucial not only for calibration but also for potential adaptation of the proposed cut-off for referral. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e83-e84 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sebastiaan Remmers More articles by this author Veeru Kasivisvanathan More articles by this author Caroline Moore More articles by this author Monique Roobol More articles by this author Ivo de Vos More articles by this author Expand All Advertisement Loading ...

Study of Serum PSA, AMACR, P63 And PTEN in Prostatic Adenocarcinoma

Background: Prostatic adenocarcinoma is the most common malignancy in older males. The present study was planned with an aim to evaluate serum PSA, expression of P63, AMACR and PTEN in prostatic carcinoma and to correlate them clinico-pathologically. It is a descriptive analytical study which includes patients of prostatic adenocarcinoma reporting to a large tertiary care hospital in Lucknow during the period of 2015-to 2017. Methods: Clinical details and complete hematological workup was done in 50 cases of prostatic adenocarcinoma during our study period of two years. Routine histopathology with hematoxylin and eosin (H & E) staining was done. Gleason grading was performed. Relevant sections were taken for Immunohistochemistry (IHC) to study PTEN, AMACR and P63. Result: Serum PSA levels ranged from 7.5 to 60 ng/ml. Half the patients had S. PSA in range 10-20 ng/ml (50%) followed by 20 ng/ml (18%) respectively. Mean S. PSA levels were 17.25+14.01 ng/ml. p63 assessment was conclusive in 48 cases. Expression of p63 was seen in 20 (41.7%) cases only (Score 1 or above). Maximum number of cases showing p63 expression had score 1 (35.4%) followed by score 2 (n=2; 4.2%) and score 3 (2.1%) respectively. AMACR assessment was conclusive in 48 cases. Expression of AMACR was seen in 47/48 (97.9%) cases. Maximum had score 2+ (n=22; 45.8%) followed by Score 3+ (n=18; 37.5%), score 1+ (n=7; 14.6%) and score 0 (n=1; 2.1%) respectively. PTEN assessment was conclusive in 46 cases. There were 21 (45.7%) cases with score 0, 16 (34.8%) with score 1 and 9 (19.6%) with score 2. Conclusion: In present study, serum PSA levels of patients ranged from 7.5 to 60 ng/ml with half having S. PSA in 10-20 ng/ml range (50%). According to AJCC criteria, S. PSA levels <10 ng/ml are in general indicators of lower severity of prostate cancer while those in 10-20 ng/ml range indicate an intermediate severity of prostate cancer.

133 PSA-pyramid in men with low range PSA: PCa incidence and mortality – a plea for risk-based prostate cancer screening strategy in the European Randomized study of Screening for Prostate Cancer (ERSPC), Aarau

133 PSA-pyramid in men with low range PSA: PCa incidence and mortality – a plea for risk-based prostate cancer screening strategy in the European Randomized study of Screening for Prostate Cancer (ERSPC), Aarau