Investig Clin Urol.  2020 Jan;61(1):42-50. 10.4111/icu.2020.61.1.42.

Preoperative prostate health index and %p2PSA as the significant biomarkers of postoperative pathological outcomes of prostate cancer in Korean males: A prospective multi-institutional study

Affiliations
  • 1Department of Urology, Kangwon National University School of Medicine, Chuncheon, Korea. Urodr348@kangwon.ac.kr
  • 2Department of Urology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
  • 3Department of Urology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.
  • 4Department of Urology, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea.

Abstract

PURPOSE
To evaluate the clinical utility of percentage of serum prostate-specific antigen (proPSA) to free PSA (%p2PSA) and the prostate health index (PHI) for predicting aggressive pathological outcomes of radical prostatectomy (RP) in Korean males.
MATERIALS AND METHODS
This prospective observational multicenter study included 160 Korean males who consecutively underwent RP. The predictive utility of preoperative %p2PSA and PHI for predicting the following pathological outcomes of RP including pT3 disease, pathologic Gleason sum ≥7, and Gleason sum upgrading was investigated using multivariate and decision-curve analyses.
RESULTS
The PHI and %p2PSA levels were significantly higher in patients with pT3 disease, pathologic Gleason sum ≥7, and Gleason sum upgrading. On univariate analysis, PHI was an accurate predictor of pT3 disease, pathologic Gleason sum ≥7, and Gleason sum upgrading. Multivariate and decision curve analyses revealed that inclusion of PHI to a base multivariate model including total PSA, percentage free PSA, PSA density, percentage of positive biopsy core, biopsy Gleason sum, and clinical stage factors significantly increased its predictive accuracy; %p2PSA showed a similar result. However, PHI was a more valuable predictor of pathological outcomes of RP.
CONCLUSIONS
This study revealed PHI and %p2PSA as preoperative biomarkers of pathological outcomes in Korean males who underwent RP for prostate cancer.

Keyword

Pathology; Prostatectomy; Prostatic neoplasms

MeSH Terms

Biomarkers*
Biopsy
Humans
Male*
Pathology
Prospective Studies*
Prostate*
Prostate-Specific Antigen
Prostatectomy
Prostatic Neoplasms*
Biomarkers
Prostate-Specific Antigen
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