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The ability of free to total prostate-specific antigen and prostate-specific antigen density to detect clinically significant prostate cancer in men undergoing transperineal template biopsy

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Title: The ability of free to total prostate-specific antigen and prostate-specific antigen density to detect clinically significant prostate cancer in men undergoing transperineal template biopsy
Authors: Segaran, SV
Emara, AM
Mahesan, T
Silverman, J
Ahmed, HU
Bott, SRJ
Hindley, RG
Item Type: Journal Article
Abstract: The ability of free to total prostate-specific antigen and prostate-specific antigen density to detect clinically significant prostate cancer in men undergoing transperineal template biopsy Show all authors Surayne V Segaran, Amr M Emara, Tharani Mahesan, ... First Published September 12, 2017 Research Article Download PDFPDF download for The ability of free to total prostate-specific antigen and prostate-specific antigen density to detect clinically significant prostate cancer in men undergoing transperineal template biopsy Article information Full Access Article Information Volume: 10 issue: 6, page(s): 529-534 Article first published online: September 12, 2017; Issue published: November 1, 2017 Received: May 04, 2017; Accepted: August 08, 2017 https://doi.org/10.1177/2051415817730494 Surayne V Segaran1, Amr M Emara1, 2, Tharani Mahesan3, Joshua Silverman1, Hashim U Ahmed4, Simon RJ Bott3, Richard G Hindley1 1Urology Department, North Hampshire Hospitals NHS Trust, UK 2Urology Department, Ain Shams University, Egypt 3Urology Department, Frimley Park Hospital, UK 4Imperial College London, UK Corresponding Author: Surayne V Segaran, Urology Department, North Hampshire Hospitals NHS Trust, Aldermaston Road, Basingstoke, RG24 9NA, UK. Email: surayne.segaran@fhft.nhs.uk Abstract Objective: The purpose of this study was to determine the ability of the ratio of free to total prostate-specific antigen and prostate-specific antigen density to predict the presence of clinically significant prostate cancer on template biopsies. The value of these tests may be underestimated as they were previously validated against sextant transrectal biopsy of the prostate, which has been proved to miss a large proportion of significant prostate cancers. The ability of these tests to specifically detect clinically significant cancers has not previously been studied. Patients and methods: A retrospective analysis was performed of patients undergoing transperineal template biopsy who also had free to total prostate-specific antigen and prostate-specific antigen density. Receiver-operating characteristic analysis was performed to determine the comparative utility of each test in the detection of all cancers as well as clinically significant cancers, by means of the area under the curve. Results: Data from 293 patients were analysed. Prostate cancer was detected in 72% of patients, of which 62% of this group had clinically significant disease. Receiver-operating characteristic analysis demonstrated the superiority of prostate-specific antigen density and free to total prostate-specific antigen over standard prostate-specific antigen in the overall detection of cancer (area under the curve 0.662 and 0.674 vs 0.534, p=0.003 and 0.02 respectively). Both tests were even more effective in the detection of clinically significant cancers (area under the curve 0.755 and 0.715 vs 0.572, p<0.0001 and 0.009 respectively). Conclusion: The free to total prostate-specific antigen and prostate-specific antigen density both appear to perform well at detecting clinically significant prostate cancer in our population of men undergoing template biopsy. The potential role of these inexpensive tests should not be overlooked as they may be of value when deciding which patients require biopsy following an initial magnetic resonance imaging scan and also for those on surveillance protocols.
Issue Date: 12-Sep-2017
Date of Acceptance: 8-Aug-2017
URI: http://hdl.handle.net/10044/1/54227
DOI: https://dx.doi.org/10.1177/2051415817730494
ISSN: 2051-4158
Publisher: SAGE PUBLICATIONS LTD
Start Page: 529
End Page: 534
Journal / Book Title: JOURNAL OF CLINICAL UROLOGY
Volume: 10
Issue: 6
Copyright Statement: © 2017 British Association of Urological Surgeons. Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/2051415817730494 journals.sagepub.com/home/uro. The final, definitive version of this paper has been published in Journal of Clinical Urology 2017, Vol. 10(6) 529 –534 by Sage Publications Ltd. All rights reserved. It is available at: https://dx.doi.org/10.1177/2051415817730494
Sponsor/Funder: Wellcome Trust
Funder's Grant Number: 204998/Z/16/Z
Keywords: Science & Technology
Life Sciences & Biomedicine
Urology & Nephrology
Free to total prostate-specific antigen
prostate cancer
prostate-specific antigen
prostate-specific antigen density
template biopsy
RISK CALCULATOR
PERCENTAGE
DISEASE
PCA3
Publication Status: Published
Appears in Collections:Division of Surgery
Faculty of Medicine



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