Evaluation of molecular forms of prostate-specific antigen and human kallikrein 2 in predicting biochemical failure after radical prostatectomy Journal Article


Authors: Wenske, S.; Korets, R.; Cronin, A. M.; Vickers, A. J.; Fleisher, M.; Scher, H. I.; Pettersson, K.; Guillonneau, B.; Scardino, P. T.; Eastham, J. A.; Lilja, H.
Article Title: Evaluation of molecular forms of prostate-specific antigen and human kallikrein 2 in predicting biochemical failure after radical prostatectomy
Abstract: Most pretreatment risk-assessment models to predict biochemical recurrence (BCR) after radical prostatectomy (RP) for prostate cancer rely on total prostate-specific antigen (PSA), clinical stage, and biopsy Gleason grade. We investigated whether free PSA (fPSA) and human glandular kallikrein-2 (hK2) would enhance the predictive accuracy of this standard model. Preoperative serum samples and complete clinical data were available for 1,356 patients who underwent RP for localized prostate cancer from 1993 to 2005. A case-control design was used, and conditional logistic regression models were used to evaluate the association between preoperative predictors and BCR after RP. We constructed multivariable models with fPSA and hK2 as additional preoperative predictors to the base model. Predictive accuracy was assessed with the area under the ROC curve (AUC). There were 146 BCR cases; the median follow up for patients without BCR was 3.2 years. Overall, 436 controls were matched to 146 BCR cases. The AUC of the base model was 0.786 in the entire cohort; adding fPSA and hK2 to this model enhanced the AUC to 0.798 (p = 0.053), an effect largely driven by fPSA. In the subgroup of men with total PSA ≤10 ng/ml (48% of cases), adding fPSA and hK2 enhanced the AUC of the base model to a similar degree (from 0.720 to 0.726, p = 0.2). fPSA is routinely measured during prostate cancer detection. We suggest that the role of fPSA in aiding preoperative prediction should be investigated in further cohorts. © 2008 Wiley-Liss, Inc.
Keywords: controlled study; human tissue; unclassified drug; major clinical study; case control study; case-control studies; histopathology; area under the curve; preoperative evaluation; prostate specific antigen; neoplasm recurrence, local; clinical assessment; tumor markers, biological; pathology; tumor marker; prostate cancer; prostate-specific antigen; prostatic neoplasms; blood; blood sampling; prostatectomy; tumor recurrence; prostate tumor; psa; kallikrein; prediction and forecasting; predictive value of tests; radical prostatectomy; area under curve; biochemical recurrence; isoprotein; protein isoforms; roc curve; free psa; human kallikrein 2; kallikrein 2 enzyme; tissue kallikrein; tissue kallikreins
Journal Title: International Journal of Cancer
Volume: 124
Issue: 3
ISSN: 0020-7136
Publisher: John Wiley & Sons  
Date Published: 2009-02-01
Start Page: 659
End Page: 663
Language: English
DOI: 10.1002/ijc.23983
PUBMED: 19003994
PROVIDER: scopus
PMCID: PMC2776773
DOI/URL:
Notes: --- - "Cited By (since 1996): 3" - "Export Date: 30 November 2010" - "CODEN: IJCNA" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Ruslan Korets
    9 Korets
  2. Peter T Scardino
    621 Scardino
  3. Sven Wenske
    5 Wenske
  4. Hans Gosta Lilja
    286 Lilja
  5. Andrew J Vickers
    556 Vickers
  6. Angel M Cronin
    145 Cronin
  7. James Eastham
    426 Eastham
  8. Martin Fleisher
    236 Fleisher
  9. Howard Scher
    816 Scher