Individual patient data meta-analysis of discrimination of the four kallikrein panel associated with the inclusion of prostate volume Journal Article

   

Authors:	Vertosick, E. A.; Zappala, S.; Punnen, S.; Hugosson, J.; Boorjian, S. A.; Haese, A.; Carroll, P.; Cooperberg, M.; Bjartell, A.; Lilja, H.; Vickers, A. J.
Article Title:	Individual patient data meta-analysis of discrimination of the four kallikrein panel associated with the inclusion of prostate volume
Abstract:	Objective: To assess whether adding prostate volume to the kallikrein panel improves discrimination for ISUP Grade Group 2 or higher (GG2+) disease, as some men may have volume measurements available at the time of blood draw. While prostate volume predicts biopsy outcome, it requires an imaging procedure for measurement. The four kallikrein panel - commercially available as the 4Kscore - predicts risk of GG2+ disease and requires only a blood draw. Materials and Methods: A total of 9131 patients with available prostate volume and total PSA ≤25 ng/ml from 5 historical (sextant biopsy, pre-ISUP 2005 grading) and 4 contemporary cohorts (10+ cores, ISUP 2005 grading). Previously published kallikrein panel models were used to predict risk of GG2+. Volume was added to the model in each cohort and change in discrimination was meta-analyzed. Results: Increased prostate volume was associated with decreased risk of GG2+ disease after controlling for the kallikrein panel in 7/9 cohorts. However, kallikrein panel discrimination (0.817, 95% CI 0.802, 0.831) was not improved after including volume (AUC difference 0.002, 95% CI -0.003, 0.006). Heterogeneity (P <.0001) was driven by an AUC increase in 1 cohort of academic cancer centers (0.044, 95% CI 0.025, 0.064), with no evidence of heterogeneity after excluding this cohort (P = .15). Conclusion: The kallikrein panel provides a non-invasive approach to assess the risk of high-grade prostate cancer. Our results do not justify the inclusion of prostate volume in the four kallikrein panel. There is some evidence that the predictive value of prostate volume is provider dependent: further research is needed to address this question. © 2021 Elsevier Inc.
Journal Title:	Urology
Volume:	157
ISSN:	0090-4295
Publisher:	Elsevier Science, Inc.
Date Published:	2021-11-01
Start Page:	102
End Page:	106
Language:	English
DOI:	10.1016/j.urology.2021.08.014
PUBMED:	34450175
PROVIDER:	scopus
PMCID:	PMC8671182
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85115236189&doi=10.1016%2fj.urology.2021.08.014&partnerID=40&md5=3d7b771aadc388a12d965d1cad8d5e7e
Notes:	Article -- Export Date: 3 January 2022 -- Source: Scopus

https://synapse.mskcc.org/synapse/works/has_related_data_chk/191783