Advertisement
Advertise here Publish your press releases here Sponsor BioPortfolio
Follow us on Twitter Sign up for daily news and research emails Contributors wanted

Biopsy and treatment decisions in the initial management of prostate cancer and the role of PCA3; a systematic analysis of expert opinion.

18:08 EDT 19th April 2014 | BioPortfolio

Summary of "Biopsy and treatment decisions in the initial management of prostate cancer and the role of PCA3; a systematic analysis of expert opinion."


PURPOSE:
The Prostate CAncer gene 3 (PCA3) assay may guide prostate biopsy decisions and predict prostate cancer (PCa) aggressiveness. This study explored the appropriateness of (1) PCA3 testing; (2) biopsy; (3) active surveillance (AS) and the value of the PCA3 Score for biopsy and AS decisions.
METHODS:
Using the RAND/UCLA appropriateness method, 12 urologists assessed the appropriateness of PCA3, biopsy and AS for theoretical patient profiles, constructed by combining clinical variables. They individually scored the appropriateness for all profiles using a 9-point scale. Based on the median score and extent of agreement, the appropriateness for each profile was calculated.
RESULTS:
The PCA3 Assay was mainly considered appropriate in men with ≥1 negative biopsy, PSA ≥ 3 ng/mL and life expectancy (LE) ≥10 years. A LE < 10 years, ≥2 negative biopsies and PCA3 Score <20 decreased biopsy appropriateness, while PSA ≥ 3 ng/mL and PCA3 Score >50 increased it. In men without a prior biopsy, LE ≥ 10 years and a suspicious DRE, PCA3 did not affect biopsy appropriateness. In other men, a PCA3 Score <20 discouraged biopsy, while a value ≥35 supported biopsy. AS was mainly considered appropriate if LE < 10 years, T1c PCa, ≤20% positive cores and PSA < 3 ng/mL. A PCA3 Score <20 pleads for and higher scores (particularly >50) against AS.
CONCLUSIONS:
These findings illustrate in which men PCA3 can be of additional value when taking biopsy and treatment decisions in clinical practice.

Affiliation

Service d'Urologie, Cliniques Universitaires Saint-Luc UCL, Avenue Hippocrate, 10, 1200, Bruxelles, Belgium, bertrand.tombal@uclouvain.be.

Journal Details

This article was published in the following journal.

Name: World journal of urology
ISSN: 1433-8726
Pages:

Links

PubMed Articles [34438 Associated PubMed Articles listed on BioPortfolio]

Can microfocal prostate cancer be regarded as low-risk prostate cancer?

Prostate specific antigen (PSA) screening for prostate cancer has become widespread, the prostate biopsy technique has evolved, and the occurrence of low-risk prostate cancer has been increasing. Even...

How accurate is our prediction of biopsy outcome? PCA3-based nomograms in personalized diagnosis of prostate cancer.

The sensitivity and specificity of prostate-specific antigen (PSA) alone to select men for prostate biopsy remain suboptimal. This review aims at presenting a review of current prostate cancer (PCa) n...

Role of endorectal prostate MRI in patients with initial suspicion of prostate cancer.

To evaluate the role of conventional endorectal prostate MRI in patients with initial suspicion of prostate cancer.

Combination of clinical characteristics and transrectal ultrasound-guided biopsy to predict lobes without significant cancer: application in patient selection for hemiablative focal therapy.

A major limitation of performing hemiablative focal therapy (FT) for prostate cancer (PCa) is the possibility of accompanying significant cancer in the contralateral side of the prostate that is misse...

Prostate cancer detection rate in patients with fluctuating prostate-specific antigen levels on the repeat prostate biopsy.

To evaluate whether the risk of prostate cancer was different according to the pattern of fluctuation in prostate-specific antigen (PSA) levels in patients undergoing repeat transrectal ultrasound-gui...

Clinical Trials [7579 Associated Clinical Trials listed on BioPortfolio]

Treatment Decision Intervention for Veterans With Prostate Cancer

Newly diagnosed localized prostate cancer patients face difficult decisions about treatment and management; including radiation therapy, radical prostatectomy, brachytherapy, and observati...

A Trial of PROSCAR (Finasteride) Versus Placebo in Men With an Initial Negative Prostate Biopsy

The purpose of this study is to assess whether six months of daily finasteride (PROSCAR), following an initial negative prostate biopsy, will improve the detection of prostate cancer on re...

Role of Dutasteride in Patients Undergoing 3D Mapping Biopsy in Early Stage Prostate Cancer

This is a study of men who have undergone a standard 10 or more core biopsy for detection of prostate cancer and determined to have prostate cancer Gleason score ≤ 7 (low to moderate ris...

Comparison of 20-core Versus 12-core Prostate Biopsy Diagnostic Performance in the Detection of Prostate Cancer

The optimal number of prostate cores extracted during a prostate biopsy performed because of a suspected prostate cancer is still debated. The present consensus is to sample 12 cores. Howe...

Prostate Biopsy Antisepsis

During a prostate biopsy, a needle is guided through the rectum into the prostate. Although patients are given antibiotics before the biopsy, there is still a risk of bacteria getting from...

Medical and Biotech [MESH] Definitions

Participation of employees with management as a labor-management team, in decisions pertaining to the operational activities of the organization or industry.

A glycoprotein that is a kallikrein-like serine proteinase and an esterase, produced by epithelial cells of both normal and malignant prostate tissue. It is an important marker for the diagnosis of prostate cancer.

A plant genus of the family LAMIACEAE that contains macrocalin B. R. japonica is an ingredient of PC-SPES, a treatment for prostate cancer.

Administrator-selected management groups who are responsible for making decisions pertaining to the provision of integrated direction for various institutional functions.

Computer-based systems that enable management to interrogate the computer on an ad hoc basis for various kinds of information in the organization, which predict the effect of potential decisions.

Search BioPortfolio: