Objective
To evaluate whether preoperative urinary prostate cancer antigen 3 (PCA3) scores predict
for adverse pathologic features (APFs) or progression-free survival (PFS) in men with
intermediate- or high-risk prostate cancer (PCa) undergoing radical prostatectomy
(RP).
Materials and Methods
One hundred nine men with intermediate- (n = 52) or high-risk (n = 57) PCa who underwent
RP were retrospectively identified. Logistic regression analysis was performed to
evaluate the association of PCA3 score with various APFs (eg, extracapsular extension,
seminal vesicle invasion, etc.). Among 78 men with ≥1 year of follow-up, the association
between PCA3 score and PFS was assessed using Cox regression analysis.
Results
At RP, 52% of patients had at least 1 APF, and with median follow-up of 2.3 years,
overall 3-year PFS was 70%. PCA3 was not a significant predictor of any APF on multivariate
analysis (MVA), whereas canonical predictors (eg, biopsy Gleason score and initial
prostate-specific antigen) remained predictive of various APFs. No significant predictors
for PFS were found on MVA, although certain canonical predictors (eg, National Comprehensive
Cancer Network risk group) were significant predictors of PFS on univariate analysis
(UVA). PCA3 score was not a significant predictor of PFS on either UVA or MVA.
Conclusion
Unlike in lower risk cohorts, increasing PCA3 score was not associated with any APF
in this higher risk cohort, despite enrichment for APFs, nor was it associated with
PFS. Notably, multiple known preoperative predictors for APFs were significant on
MVA, and multiple predictors were associated with PFS on UVA. Therefore, PCA3 may
not be a useful adjunct predictive marker in men with intermediate- or high-risk PCa.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to UrologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- PCA3 molecular urine assay for prostate cancer in men undergoing repeat biopsy.Urology. 2007; 69: 532-535
- Prostate cancer gene 3 (PCA3): development and internal validation of a novel biopsy nomogram.Eur Urol. 2009; 56: 659-667
- Urinary prostate cancer 3 test: toward the age of reason?.Urology. 2010; 75: 447-453
- Initial prostate biopsy: development and internal validation of a biopsy-specific nomogram based on the prostate cancer antigen 3 assay.Eur Urol. 2013; 63: 201-209
- PCA3 molecular urine assay correlates with prostate cancer tumor volume: implication in selecting candidates for active surveillance.J Urol. 2008; 179 (discussion 1809-1810): 1804-1809
- PCA3 score before radical prostatectomy predicts extracapsular extension and tumor volume.J Urol. 2008; 180 (discussion 1978-1979): 1975-1978
- Prostate cancer antigen 3 score accurately predicts tumour volume and might help in selecting prostate cancer patients for active surveillance.Eur Urol. 2011; 59: 422-429
- Urinary PCA3 score predicts prostate cancer multifocality.J Urol. 2011; 185: 1234-1239
- The relationship between Prostate CAncer gene 3 (PCA3) and prostate cancer significance.BJU Int. 2012; 109: 360-366
- The value of urinary prostate cancer gene 3 (PCA3) scores in predicting pathological features at radical prostatectomy.BJU Int. 2012; 110: 43-49
- Improving the prediction of pathologic outcomes in patients undergoing radical prostatectomy: the value of prostate cancer antigen 3 (PCA3), prostate health index (phi) and sarcosine.Anticancer Res. 2015; 35: 1017-1023
- Detailed analysis of histopathological parameters in radical prostatectomy specimens and PCA3 urine test results.Prostate. 2008; 68: 1215-1222
- Predictive value of PCA3 in urinary sediments in determining clinico-pathological characteristics of prostate cancer.Prostate. 2010; 70: 10-16
- Relationship between prostate cancer gene 3 (PCA3) and characteristics of tumor aggressiveness.Prostate. 2013; 73: 203-210
- In-parallel comparative evaluation between multiparametric magnetic resonance imaging, prostate cancer antigen 3 and the prostate health index in predicting pathologically confirmed significant prostate cancer in men eligible for active surveillance.BJU Int. 2016; 118: 527-534
- APTIMA PCA3 molecular urine test: development of a method to aid in the diagnosis of prostate cancer.Clin Chem. 2006; 52: 1089-1095
- The 2005 International Society of Urological Pathology (ISUP) consensus conference on Gleason grading of prostatic carcinoma.Am J Surg Pathol. 2005; 29: 1228-1242
- The 2014 International Society of Urological Pathology (ISUP) consensus conference on Gleason grading of prostatic carcinoma: definition of grading patterns and proposal for a new grading system.Am J Surg Pathol. 2016; 40: 244-252
- Variation in the definition of biochemical recurrence in patients treated for localized prostate cancer: the American Urological Association Prostate Guidelines for Localized Prostate Cancer Update Panel report and recommendations for a standard in the reporting of surgical outcomes.J Urol. 2007; 177: 540-545
- Contemporary evaluation of the National Comprehensive Cancer Network prostate cancer risk classification system.Urology. 2012; 80: 1075-1079
- Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer.JAMA. 1998; 280: 969-974
- A new risk classification system for therapeutic decision making with intermediate-risk prostate cancer patients undergoing dose-escalated external-beam radiation therapy.Eur Urol. 2013; 64: 895-902
- Redefining high-risk prostate cancer based on distant metastases and mortality after high-dose radiotherapy with androgen deprivation therapy.Int J Radiat Oncol Biol Phys. 2012; 82: 1397-1404
- Patients with biopsy Gleason 9 and 10 prostate cancer have significantly worse outcomes compared to patients with Gleason 8 disease.J Urol. 2015; 194: 91-97
- The prognostic role of tertiary Gleason pattern 5 in a contemporary grading system for prostate cancer.Prostate Cancer Prostatic Dis. 2017; 20: 93-98
- Natural history of progression after PSA elevation following radical prostatectomy.JAMA. 1999; 281: 1591-1597
- Low PCA3 expression is a marker of poor differentiation in localized prostate tumors: exploratory analysis from 12,076 patients.Oncotarget. 2017; https://doi.org/10.18632/oncotarget.15133
- Can urinary PCA3 supplement PSA in the early detection of prostate cancer?.J Clin Oncol. 2014; 32: 4066-4072
- Urine TMPRSS2:ERG plus PCA3 for individualized prostate cancer Risk assessment.Eur Urol. 2016; 70: 45-53
- Prospective multicentre evaluation of PCA3 and TMPRSS2-ERG gene fusions as diagnostic and prognostic urinary biomarkers for prostate cancer.Eur Urol. 2014; 65: 534-542
Article info
Publication history
Published online: May 25, 2017
Accepted:
May 17,
2017
Received:
April 12,
2017
Footnotes
Financial Disclosure: The authors declare that they have no relevant financial interests.
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
