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• W2114469722 abstract "No AccessJournal of UrologyClinical Urology: Original Articles1 Oct 1999PREDICTION OF POST-RADICAL PROSTATECTOMY PATHOLOGICAL OUTCOME FOR STAGE T1c PROSTATE CANCER WITH PERCENT FREE PROSTATE SPECIFIC ANTIGEN: A PROSPECTIVE MULTICENTER CLINICAL TRIAL PAULA C. SOUTHWICK, WILLIAM J. CATALONA, ALAN W. PARTIN, KEVIN M. SLAWIN, MICHAEL K. BRAWER, ROBERT C. FLANIGAN, ANUP PATEL, JEROME P. RICHIE, PATRICK C. WALSH, PETER T. SCARDINO, PAUL H. LANGE, GAIL H. GASIOR, ROBERT E. PARSON, and KATHLEEN G. LOVELAND PAULA C. SOUTHWICKPAULA C. SOUTHWICK More articles by this author , WILLIAM J. CATALONAWILLIAM J. CATALONA More articles by this author , ALAN W. PARTINALAN W. PARTIN More articles by this author , KEVIN M. SLAWINKEVIN M. SLAWIN More articles by this author , MICHAEL K. BRAWERMICHAEL K. BRAWER More articles by this author , ROBERT C. FLANIGANROBERT C. FLANIGAN More articles by this author , ANUP PATELANUP PATEL More articles by this author , JEROME P. RICHIEJEROME P. RICHIE More articles by this author , PATRICK C. WALSHPATRICK C. WALSH More articles by this author , PETER T. SCARDINOPETER T. SCARDINO More articles by this author , PAUL H. LANGEPAUL H. LANGE More articles by this author , GAIL H. GASIORGAIL H. GASIOR More articles by this author , ROBERT E. PARSONROBERT E. PARSON More articles by this author , and KATHLEEN G. LOVELANDKATHLEEN G. LOVELAND More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)68282-1AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Prostate specific antigen (PSA) exists in bound (complexed) and unbound (free) forms in serum. The percentage of free PSA enhances the specificity of PSA testing for prostate cancer detection. We evaluated the use of percent free PSA preoperatively to predict pathological stage. Materials and Methods: A total of 379 men with prostate cancer and 394 with benign prostatic disease 50 to 75 years old were enrolled in this prospective study at 7 medical centers. All subjects had a palpably benign prostate gland, serum PSA 4.0 to 10.0 ng./ml. and a histologically confirmed diagnosis. The Hybritech Tandem§ Hybritech, Inc., San Diego, California. PSA and free PSA assays were used. Of the 379 cancer patients 268 (71%) underwent radical prostatectomy. Results: Higher percent free PSA levels were associated with more favorable histopathological findings in prostatectomy specimens. A value of 15% free PSA provided the greatest discrimination in predicting favorable pathological outcome. Organ confined cancer, Gleason sum less than 7 and small tumors (10% or less involvement of the prostate) were noted in 75% of patients with greater than 15% and only 34% with 15% or less free PSA (p <0.001). Multivariate logistic regression analysis revealed percent free PSA to be the strongest predictor of postoperative pathological outcome (odds ratio 2.25), followed by biopsy Gleason sum (2.06) and patient age (1.35). Total PSA was not predictive in this cohort but has been shown in prior studies to be predictive of outcome when a broader range of PSA values is evaluated. Conclusions: Percent free PSA may be used for risk assessment of the presence (diagnosis) and stage of prostate cancer in men with PSA between 4 and 10 ng./ml. Percent free PSA may be combined with PSA, digital rectal examination and biopsy findings to help predict postoperative pathological stage and grade, and may assist the patient and physician in making more informed treatment decisions. References 1 : Cancer Statistics, 1998. CA Cancer J. Clin.1998; 48: 6. 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Google Scholar From the Division of Urologic Surgery, Washington University School of Medicine, St. Louis, Missouri, Department of Urology, The Johns Hopkins Hospital, Baltimore, Maryland, Baylor College of Medicine, Houston, Texas, University of Washington, Seattle, Washington, Loyola University Medical Center, Maywood, Illinois, Department of Research and Development, Hybritech Inc., San Diego and University of California Los Angeles, School of Medicine, Los Angeles, California, and Harvard Program in Urology, Brigham and Women's Hospital, Boston, Massachusetts© 1999 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited ByPartin A (2016) Where it all BeganJournal of Urology, VOL. 197, NO. 2S, (S153-S153), Online publication date: 1-Feb-2017.Busch J, Hamborg K, Meyer H, Buckendahl J, Magheli A, Lein M, Jung K, Miller K and Stephan C (2018) Value of Prostate Specific Antigen Density and Percent Free Prostate Specific Antigen for Prostate Cancer PrognosisJournal of Urology, VOL. 188, NO. 6, (2165-2170), Online publication date: 1-Dec-2012.SINGH H, CANTO E, SHARIAT S, KADMON D, MILES B, WHEELER T and SLAWIN K (2018) Six Additional Systematic Lateral Cores Enhance Sextant Biopsy Prediction of Pathological Features at Radical ProstatectomyJournal of Urology, VOL. 171, NO. 1, (204-209), Online publication date: 1-Jan-2004.HAESE A, GRAEFEN M, STEUBER T, BECKER C, NOLDUS J, ERBERSDOBLER A, HULAND E, HULAND H and LILJA H (2018) Total and Gleason Grade 4/5 Cancer Volumes are Major Contributors of Human Kallikrein 2, Whereas Free Prostate Specific Antigen is Largely Contributed by Benign Gland Volume in Serum From Patients With Prostate Cancer or Benign Prostatic BiopsiesJournal of Urology, VOL. 170, NO. 6, (2269-2273), Online publication date: 1-Dec-2003.GRAEFEN M, KARAKIEWICZ P, CAGIANNOS I, HAMMERER P, HAESE A, PALISAAR J, HULAND E, SCARDINO P, KATTAN M and HULAND H (2018) PERCENT FREE PROSTATE SPECIFIC ANTIGEN IS NOT AN INDEPENDENT PREDICTOR OF ORGAN CONFINEMENT OR PROSTATE SPECIFIC ANTIGEN RECURRENCE IN UNSCREENED PATIENTS WITH LOCALIZED PROSTATE CANCER TREATED WITH RADICAL PROSTATECTOMYJournal of Urology, VOL. 167, NO. 3, (1306-1309), Online publication date: 1-Mar-2002.ELLIS W, ETZIONI R, VESSELLA R, HU C and GOODMAN G (2018) SERIAL PROSTATE SPECIFIC ANTIGEN, FREE-TO-TOTAL PROSTATE SPECIFIC ANTIGEN RATIO AND COMPLEXED PROSTATE SPECIFIC ANTIGEN FOR THE DIAGNOSIS OF PROSTATE CANCERJournal of Urology, VOL. 166, NO. 1, (93-99), Online publication date: 1-Jul-2001.GROSSKLAUS D, SHAPPELL S, GAUTAM S, SMITH J and COOKSON M (2018) RATIO OF FREE-TO-TOTAL PROSTATE SPECIFIC ANTIGEN CORRELATES WITH TUMOR VOLUME IN PATIENTS WITH INCREASED PROSTATE SPECIFIC ANTIGENJournal of Urology, VOL. 165, NO. 2, (455-458), Online publication date: 1-Feb-2001. Volume 162Issue 4October 1999Page: 1346-1351 Advertisement Copyright & Permissions© 1999 by American Urological Association, Inc.Keywordsprostateprostatic neoplasmsprostate-specific antigenneoplasm stagingMetricsAuthor Information PAULA C. SOUTHWICK More articles by this author WILLIAM J. CATALONA More articles by this author ALAN W. PARTIN More articles by this author KEVIN M. SLAWIN More articles by this author MICHAEL K. BRAWER More articles by this author ROBERT C. FLANIGAN More articles by this author ANUP PATEL More articles by this author JEROME P. RICHIE More articles by this author PATRICK C. WALSH More articles by this author PETER T. SCARDINO More articles by this author PAUL H. LANGE More articles by this author GAIL H. GASIOR More articles by this author ROBERT E. PARSON More articles by this author KATHLEEN G. LOVELAND More articles by this author Expand All Advertisement PDF DownloadLoading ..." @default.
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• W2114469722 title "PREDICTION OF POST-RADICAL PROSTATECTOMY PATHOLOGICAL OUTCOME FOR STAGE T1c PROSTATE CANCER WITH PERCENT FREE PROSTATE SPECIFIC ANTIGEN: A PROSPECTIVE MULTICENTER CLINICAL TRIAL" @default.
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