Understanding PSA and its derivatives in prediction of tumor volume: addressing health disparities in prostate cancer risk stratification
Metrics: PDF 1484 views | HTML 1852 views | ?
Felix M. Chinea1,6, Kirill Lyapichev2, Jonathan I. Epstein7, Deukwoo Kwon4,6, Paul Taylor Smith2, Alan Pollack1,6, Richard J. Cote2,5,6, Oleksandr N. Kryvenko2,3,6
1Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, FL, USA
2Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
3Urology, University of Miami Miller School of Medicine, Miami, FL, USA
4Biostatistics, University of Miami Miller School of Medicine, Miami, FL, USA
5Biochemistry, University of Miami Miller School of Medicine, Miami, FL, USA
6Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
7Departments of Pathology, Urology, and Oncology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA
Oleksandr N. Kryvenko, email: [email protected]
Keywords: prostate cancer, prostate specific antigen, health disparities, Hispanic/Latino, risk stratification
Received: October 11, 2016 Accepted: January 10, 2017 Published: January 30, 2017
Objectives: To address health disparities in risk stratification of U.S. Hispanic/Latino men by characterizing influences of prostate weight, body mass index, and race/ethnicity on the correlation of PSA derivatives with Gleason score 6 (Grade Group 1) tumor volume in a diverse cohort.
Results: Using published PSA density and PSA mass density cutoff values, men with higher body mass indices and prostate weights were less likely to have a tumor volume <0.5 cm3. Variability across race/ethnicity was found in the univariable analysis for all PSA derivatives when predicting for tumor volume. In receiver operator characteristic analysis, area under the curve values for all PSA derivatives varied across race/ethnicity with lower optimal cutoff values for Hispanic/Latino (PSA=2.79, PSA density=0.06, PSA mass=0.37, PSA mass density=0.011) and Non-Hispanic Black (PSA=3.75, PSA density=0.07, PSA mass=0.46, PSA mass density=0.008) compared to Non-Hispanic White men (PSA=4.20, PSA density=0.11 PSA mass=0.53, PSA mass density=0.014).
Materials and Methods: We retrospectively analyzed 589 patients with low-risk prostate cancer at radical prostatectomy. Pre-operative PSA, patient height, body weight, and prostate weight were used to calculate all PSA derivatives. Receiver operating characteristic curves were constructed for each PSA derivative per racial/ethnic group to establish optimal cutoff values predicting for tumor volume ≥0.5 cm3.
Conclusions: Increasing prostate weight and body mass index negatively influence PSA derivatives for predicting tumor volume. PSA derivatives’ ability to predict tumor volume varies significantly across race/ethnicity. Hispanic/Latino and Non-Hispanic Black men have lower optimal cutoff values for all PSA derivatives, which may impact risk assessment for prostate cancer.
All site content, except where otherwise noted, is licensed under a Creative Commons Attribution 4.0 License.