Independent validation of a pre-specified four-kallikrein marker model for prediction of adverse pathology and biochemical recurrence Journal Article

   

Authors:	Rasmussen, M.; Fredsøe, J.; Tin, A. L.; Vickers, A. J.; Ulhøi, B.; Borre, M.; Eastham, J.; Ehdaie, B.; Guillonneau, B.; Laudone, V.; Scardino, P. T.; Touijer, K.; Sørensen, K. D.; Lilja, H.
Article Title:	Independent validation of a pre-specified four-kallikrein marker model for prediction of adverse pathology and biochemical recurrence
Abstract:	Background: Accurate markers for prostate cancer (PC) risk stratification could aid decision-making for initial management strategies. The 4Kscore has an undefined role in predicting outcomes after radical prostatectomy (RP). Methods: We included 1476 patients with 4Kscore measured prior to RP at two institutions. The 4Kscore was assessed for prediction of adverse pathology at RP and biochemical recurrence (BCR) relative to a clinical model. We pre-specified that all analyses would be assessed in biopsy Grade Group 1 (GG1) or 2 (GG2) PC patients, separately. Results: The 4Kscore increased discrimination for adverse pathology in all patients (delta area under the receiver operative curve (AUC) 0.009, 95% confidence interval (CI) 0.002, 0.016; clinical model AUC 0.767), driven by GG1 (delta AUC 0.040, 95% CI 0.006, 0.073) rather than GG2 patients (delta AUC 0.005, 95% CI −0.012, 0.021). Adding 4Kscore improved prediction of BCR in all patients (delta C-index 0.014, 95% CI 0.007, 0.021; preop-BCR nomogram C-index 0.738), again with larger changes in GG1 than in GG2. Conclusions: This study validates prior investigations on the use of 4Kscore in men with biopsy-confirmed PC. Men with GG1 PC and a high 4Kscore may benefit from additional testing to guide treatment selection. Further research is warranted regarding the value of the 4Kscore in men with biopsy GG2 PC. © 2021, The Author(s), under exclusive licence to Springer Nature Limited.
Keywords:	cancer grading; prostate specific antigen; pathology; prostate-specific antigen; prostatic neoplasms; prostate; prostatectomy; prostate tumor; kallikrein; kallikreins; neoplasm grading; humans; human; male
Journal Title:	British Journal of Cancer
Volume:	126
Issue:	7
ISSN:	0007-0920
Publisher:	Nature Publishing Group
Date Published:	2022-04-01
Start Page:	1004
End Page:	1009
Language:	English
DOI:	10.1038/s41416-021-01661-x
PUBMED:	34903844
PROVIDER:	scopus
PMCID:	PMC8980060
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85121104641&doi=10.1038%2fs41416-021-01661-x&partnerID=40&md5=c0c1dfe05609e17bed23116018d9a5ea
Notes:	Article -- Export Date: 25 April 2022 -- Source: Scopus

https://synapse.mskcc.org/synapse/works/has_related_data_chk/193970