Performance characteristics of prostate-specific antigen in patients undergoing radical prostatectomy

Jen-Jane Liu, Michelle Ferrari, Rosie Nolley, James D. Brooks, Joseph C. Presti

Research output: Contribution to journalArticle

Abstract

Objective: To assess the performance characteristics of prostate-specific antigen (PSA) for predicting the volume of total or high-grade cancer in men undergoing radical prostatectomy. It is known that the performance characteristics of PSA are improved for predicting the presence of high-grade prostate cancer. Methods: We identified 1459 patients from the Stanford Radical Prostatectomy Database with clinical Stage T1c (n = 783) and T2 (n = 676) disease who underwent surgery from 1988 to 2003 with detailed morphometric mapping. We generated receiver operating characteristic curves for PSA levels according to the total and high-grade (Gleason score 4 or 5) cancer volume and compared the areas under the curve (AUC) for the various total and high-grade cancer volumes. Results: For patients with Stage T1c disease, the AUC for the PSA ROC curve increased in a stepwise fashion as both the total cancer volume and the high-grade cancer volume increased. Significant differences between the AUCs for low and high volumes of total and high-grade disease were observed. For T2 disease, the AUCs for predicting high-grade cancer volume were generally greater than the corresponding AUCs for T1c disease, although no incremental increase was observed. Conclusion: In patients with Stage T1c disease, in whom the PSA level was the driving force for biopsy, the PSA performance improved in a stepwise fashion with greater total and high-grade cancer volumes as evidenced by improved ROC. Previous studies have shown that PSA performs better for detecting the presence of high-grade disease. We have shown that PSA performs better in predicting greater volumes of high-grade disease in radical prostatectomy specimens.

Original languageEnglish (US)
Pages (from-to)1336-1339
Number of pages4
JournalUrology
Volume79
Issue number6
DOIs
StatePublished - Jun 2012
Externally publishedYes

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Prostate-Specific Antigen
Prostatectomy
Area Under Curve
Neoplasms
ROC Curve
Neoplasm Grading
Prostatic Neoplasms
Databases
Biopsy

ASJC Scopus subject areas

  • Urology

Cite this

Performance characteristics of prostate-specific antigen in patients undergoing radical prostatectomy. / Liu, Jen-Jane; Ferrari, Michelle; Nolley, Rosie; Brooks, James D.; Presti, Joseph C.

In: Urology, Vol. 79, No. 6, 06.2012, p. 1336-1339.

Research output: Contribution to journalArticle

Liu, Jen-Jane ; Ferrari, Michelle ; Nolley, Rosie ; Brooks, James D. ; Presti, Joseph C. / Performance characteristics of prostate-specific antigen in patients undergoing radical prostatectomy. In: Urology. 2012 ; Vol. 79, No. 6. pp. 1336-1339.
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