Prediction of pathological stage is inaccurate in men with PSA values above 20 ng/mL.
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Prediction of pathological stage is inaccurate in men with PSA values above 20 ng/mL. / Gallina, Andrea; Jeldres, Claudio; Chun, Felix; Shariat, Shahrokh F; Briganti, Alberto; Walz, Jochen; Roehrborn, Claus G; Saad, Fred; Huland, Hartwig; Graefen, Markus; Montorsi, Francesco; Karakiewicz, Pierre I.
In: EUR UROL, Vol. 52, No. 5, 5, 2007, p. 1374-1380.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Prediction of pathological stage is inaccurate in men with PSA values above 20 ng/mL.
AU - Gallina, Andrea
AU - Jeldres, Claudio
AU - Chun, Felix
AU - Shariat, Shahrokh F
AU - Briganti, Alberto
AU - Walz, Jochen
AU - Roehrborn, Claus G
AU - Saad, Fred
AU - Huland, Hartwig
AU - Graefen, Markus
AU - Montorsi, Francesco
AU - Karakiewicz, Pierre I
PY - 2007
Y1 - 2007
N2 - INTRODUCTION: We hypothesized that either very low (0-2.5 ng/mL) or very high (>20 ng/mL) PSA values may limit the accuracy of pathological stage predictions. To test this hypothesis, we examined 5193 consecutive patients subjected to radical prostatectomy (RP) for localized prostate cancer (PCa). MATERIAL AND METHODS: Patients were divided into three cohorts according to their pre-treatment PSA value: 20 ng/mL (n=317). Subsequently in each cohort, the ability of PSA, clinical stage and biopsy Gleason sum was tested in multivariable logistic regression models predicting three separate endpoints: extracapsular extension (ECE), seminal vesicle invasion (SVI) and lymph node invasion (LNI). Predictive accuracy represented the performance benchmark. All models were adjusted for year of surgery and subjected to 200 bootstrap resamples to reduce overfit bias. RESULTS: For PSA 20 ng/mL, predictive accuracy was 63.6%, 63.7% and 70.6%. CONCLUSIONS: The ability to predict pathological stage in patients with PSA values in excess of 20 ng/mL significantly decreased, compared to patients with lower PSA values. Therefore, accurate staging of these patients may require alternative markers or staging schemes.
AB - INTRODUCTION: We hypothesized that either very low (0-2.5 ng/mL) or very high (>20 ng/mL) PSA values may limit the accuracy of pathological stage predictions. To test this hypothesis, we examined 5193 consecutive patients subjected to radical prostatectomy (RP) for localized prostate cancer (PCa). MATERIAL AND METHODS: Patients were divided into three cohorts according to their pre-treatment PSA value: 20 ng/mL (n=317). Subsequently in each cohort, the ability of PSA, clinical stage and biopsy Gleason sum was tested in multivariable logistic regression models predicting three separate endpoints: extracapsular extension (ECE), seminal vesicle invasion (SVI) and lymph node invasion (LNI). Predictive accuracy represented the performance benchmark. All models were adjusted for year of surgery and subjected to 200 bootstrap resamples to reduce overfit bias. RESULTS: For PSA 20 ng/mL, predictive accuracy was 63.6%, 63.7% and 70.6%. CONCLUSIONS: The ability to predict pathological stage in patients with PSA values in excess of 20 ng/mL significantly decreased, compared to patients with lower PSA values. Therefore, accurate staging of these patients may require alternative markers or staging schemes.
M3 - SCORING: Zeitschriftenaufsatz
VL - 52
SP - 1374
EP - 1380
JO - EUR UROL
JF - EUR UROL
SN - 0302-2838
IS - 5
M1 - 5
ER -
