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Role of PCA3 and SelectMDx in the optimization of active surveillance in prostate cancer.
Fiorella, D; Marenco, J L; Mascarós, J M; Borque-Fernando, Á; Esteban, L M; Calatrava, A; Pastor, B; López-Guerrero, J A; Rubio-Briones, J.
Afiliación
  • Fiorella D; Departamento de Urología, Instituto Valenciano de Oncología, Valencia, Spain.
  • Marenco JL; Departamento de Urología, Instituto Valenciano de Oncología, Valencia, Spain.
  • Mascarós JM; Departamento de Urología, Instituto Valenciano de Oncología, Valencia, Spain.
  • Borque-Fernando Á; Departamento de Urología, IIS-Aragón, Hospital Universitario Miguel Servet, Zaragoza, Spain.
  • Esteban LM; Departamento de Matemáticas Aplicadas, Escuela Universitaria Politécnica de La Almunia, Universidad de Zaragoza, La Almuniade Doña Godina, Zaragoza, Spain.
  • Calatrava A; Departamento de Patología, Instituto Valenciano de Oncología, Valencia, Spain.
  • Pastor B; Laboratorio de Biología Molecular, Instituto Valenciano de Oncología, Valencia, Spain.
  • López-Guerrero JA; Laboratorio de Biología Molecular, Instituto Valenciano de Oncología, Valencia, Spain; IVO-CIPF Joint Research Unit of Cancer, Centro de Investigación Príncipe Felipe (CIPF), Valencia, Spain; Departamento de Patología, Facultad de Medicina, Universidad Católica de Valencia San Vicente Mártir, Valenc
  • Rubio-Briones J; Departamento de Urología, Instituto Valenciano de Oncología, Valencia, Spain. Electronic address: jrubio@fivo.org.
Actas Urol Esp (Engl Ed) ; 45(6): 439-446, 2021.
Article en En, Es | MEDLINE | ID: mdl-34148844
INTRODUCTION & OBJECTIVES: A not negligible percentage of patients included in active surveillance (AS) for low and very low risk prostate cancer (PCa) are reclassified in the confirmatory biopsy or have disease progression during follow-up. Our aim is to evaluate the role of PCA3 and SelectMDx, in an individual and combined way, in the prediction of pathological progression (PP) in a standard AS program. MATERIALS & METHODS: Prospective and observational study comprised of 86 patients enrolled in an AS program from 2009 to 2019, with results for PCA3 and SelectMDx previous to PCa diagnosis or during their confirmatory period. Univariate and multivariate analysis were performed to correlate PCA3 and SelectMDx scores as well as clinical and pathological variables with PP-free survival (PPFS). The most reliable cut-offs for both biomarkers in the context of AS were defined. RESULTS: SelectMDx showed statistically significant differences related to PPFS (HR 1.035, 95%CI: 1.012-1.057) (p = 0.002) with a C-index of 0.670 (95%CI: 0.529-0.810) and AUC of 0.714 (95%CI: 0.603-0.825) at 5 years. In our series, the most reliable cut-off point for SelectMDx was 5, with a sensitivity and specificity for PP of 69.8% and 67.4%, respectively. Same figure for PCA3 was 65, with a sensitivity and specificity for PP of 51.16% and 74.42%, respectively. The combination of both biomarkers did not improve the prediction of PP, C-index 0.630 (95%CI: 0.455-0.805). CONCLUSIONS: In the context of low or very low risk PCa, SelectMDx > 5 predicted 5 years PP free survival with a moderate discrimination ability outperforming PCA3. The combination of both tests did not improved outcomes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Próstata / Espera Vigilante Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Límite: Humans / Male Idioma: En / Es Revista: Actas Urol Esp (Engl Ed) Año: 2021 Tipo del documento: Article País de afiliación: España Pais de publicación: España
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Próstata / Espera Vigilante Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Límite: Humans / Male Idioma: En / Es Revista: Actas Urol Esp (Engl Ed) Año: 2021 Tipo del documento: Article País de afiliación: España Pais de publicación: España