Prostate CancerPub Date : 2018-07-26eCollection Date: 2018-01-01DOI: 10.1155/2018/5821616
Dianne van Strijp, Christiane de Witz, Pieter C Vos, Eveline den Biezen-Timmermans, Anne van Brussel, Janneke Wrobel, George S Baillie, Pierre Tennstedt, Thorsten Schlomm, Birthe Heitkötter, Sebastian Huss, Martin Bögemann, Miles D Houslay, Chris Bangma, Axel Semjonow, Ralf Hoffmann
{"title":"The Prognostic PDE4D7 Score in a Diagnostic Biopsy Prostate Cancer Patient Cohort with Longitudinal Biological Outcomes.","authors":"Dianne van Strijp, Christiane de Witz, Pieter C Vos, Eveline den Biezen-Timmermans, Anne van Brussel, Janneke Wrobel, George S Baillie, Pierre Tennstedt, Thorsten Schlomm, Birthe Heitkötter, Sebastian Huss, Martin Bögemann, Miles D Houslay, Chris Bangma, Axel Semjonow, Ralf Hoffmann","doi":"10.1155/2018/5821616","DOIUrl":"10.1155/2018/5821616","url":null,"abstract":"<p><p><i>Purpose.</i> To further validate the prognostic power of the biomarker PDE4D7, we investigated the correlation of PDE4D7 scores adjusted for presurgical clinical variables with longitudinal postsurgical biological outcomes. <i>Methods.</i> RNA was extracted from biopsy punches of resected tumors (550 patients; RP cohort) and diagnostic needle biopsies (168 patients; DB cohort). Cox regression and survival were applied to correlate PDE4D7 scores with patient outcomes. Logistic regression was used to combine the clinical CAPRA score with PDE4D7. <i>Results.</i> In univariate analysis, the PDE4D7 score was significantly associated with PSA recurrence after prostatectomy in both studied patient cohorts' analysis (HR 0.53; 95% CI 0.41-0.67; p<1.0E-04 and HR 0.47; 95% CI 0.33-0.65; p<1.0E-04, respectively). After adjustment for the presurgical clinical variables preoperative PSA, PSA density, biopsy Gleason, clinical stage, percentage tumor in the biopsy (data only available for RP cohort), and percentage of positive biopsies, the HR was 0.49 (95% CI 0.38-0.64; p<1.0E-04) and 0.43 (95% CI 0.29-0.63; p<1.0E-04), respectively. The addition of the PDE4D7 to the clinical CAPRA score increased the AUC by 5% over the CAPRA score alone (0.82 versus 0.77; p=0.004). This combination model stratified 14.6% patients of the DB cohort to no risk of biochemical relapse (NPV 100%) over a follow-up period of up to 15 years. <i>Conclusions.</i> The PDE4D7 score provides independent risk information for pretreatment risk stratification. Combining CAPRA with PDE4D7 scores significantly improved the clinical risk stratification before surgery.</p>","PeriodicalId":20907,"journal":{"name":"Prostate Cancer","volume":"2018 ","pages":"5821616"},"PeriodicalIF":4.2,"publicationDate":"2018-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6083737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36431713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Prostate CancerPub Date : 2018-03-19eCollection Date: 2018-01-01DOI: 10.1155/2018/2654572
Pedro Leonel Almeida, Bruno Jorge Pereira
{"title":"Local Treatment of Metastatic Prostate Cancer: What is the Evidence So Far?","authors":"Pedro Leonel Almeida, Bruno Jorge Pereira","doi":"10.1155/2018/2654572","DOIUrl":"https://doi.org/10.1155/2018/2654572","url":null,"abstract":"<p><strong>Background: </strong>Advances in technological, laboratorial, and imaging studies and new treatments available in the last decades significantly improved prostate cancer survival rates. However, this did not occur in metastatic prostate cancer (mPCa) at diagnosis which, in young and fit patients, will become invariably resistant to the established treatments. Progression will lead to an impairment in patients' quality of life and disease-related death.</p><p><strong>Methods: </strong>The authors intend to perform a literature review of the advantages of primary treatment of mPCa. Articles were retrieved and filtered for relevance from PubMed, SciELO, and ScienceDirect until March 2017.</p><p><strong>Results: </strong>Primary treatment is currently indicated only in cases of nonmetastatic PCa. Nonetheless, there might be some benefits in doing local treatment in mPCa in order to control local disease, prevent new metastasis, and improve the efficacy of chemotherapy and hormonotherapy with similar complications rate when compared to locally confined cancer. Independent factors that have a negative influence are age above 70 years, cT4 stage or high-grade disease, PSA ≥ 20 ng/ml, and pelvic lymphadenopathies. The presence of 3 or more of these factors conditions CSS and OS is the same between patients who performed local treatment and those who did not. Metastasis degree and location number can also influence outcome. Meanwhile, patients with visceral metastases have worse results.</p><p><strong>Conclusions: </strong>There is growing evidence supporting local treatment in cases of metastatic prostate cancer at diagnosis in the context of a multimodal approach. However, it should be kept in mind that most of the existing studies are retrospective and it would be important to make consistent prospective studies with well-defined patient selection criteria in order to sustain the existing data and understand the main indications to select patients and perform primary treatment in mPCa.</p>","PeriodicalId":20907,"journal":{"name":"Prostate Cancer","volume":"2018 ","pages":"2654572"},"PeriodicalIF":4.2,"publicationDate":"2018-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2018/2654572","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36094480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Prostate CancerPub Date : 2017-01-01Epub Date: 2017-11-21DOI: 10.1155/2017/8560827
Mike Fang, Mary Nakazawa, Emmanuel S Antonarakis, Chun Li
{"title":"Efficacy of Abiraterone and Enzalutamide in Pre- and Postdocetaxel Castration-Resistant Prostate Cancer: A Trial-Level Meta-Analysis.","authors":"Mike Fang, Mary Nakazawa, Emmanuel S Antonarakis, Chun Li","doi":"10.1155/2017/8560827","DOIUrl":"https://doi.org/10.1155/2017/8560827","url":null,"abstract":"<p><p>We examined the comparative efficacies of first-line abiraterone and enzalutamide in pre- and postdocetaxel settings in castration-resistant prostate cancer (CRPC) through a trial level meta-analysis. A mixed method approach was applied to 19 unique studies containing 17 median overall survival (OS) estimates and 13 median radiographic progression-free survival (PFS) estimates. We employed a random-effects meta-analysis to compare efficacies of abiraterone and enzalutamide with respect to OS and PFS. In the predocetaxel setting, enzalutamide use was associated with an increase in median OS of 5.9 months (<i>p</i> < 0.001), hazard ratio (HR) = 0.81, and an increase in median PFS of 8.3 months (<i>p</i> < 0.001), HR = 0.47 compared to abiraterone. The advantage of enzalutamide improved after adjusting for baseline Gleason score to 19.5 months (<i>p</i> < 0.001) and 14.6 months (<i>p</i> < 0.001) in median OS and PFS, respectively. In the postdocetaxel setting, the advantage of enzalutamide use was nominally significant for median PFS (1.2 months <i>p</i> = 0.02 without adjustment and 2.2 months and <i>p</i> = 0.0007 after adjustment); there was no significant difference in median OS between the two agents. The results from this comprehensive meta-analysis suggest a survival advantage with the use of first-line enzalutamide over abiraterone in CRPC and highlight the need for prospective clinical trials.</p>","PeriodicalId":20907,"journal":{"name":"Prostate Cancer","volume":"2017 ","pages":"8560827"},"PeriodicalIF":4.2,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2017/8560827","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35759335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Prostate CancerPub Date : 2016-01-01Epub Date: 2016-05-31DOI: 10.1155/2016/1481727
Simone Albisinni, Fouad Aoun, Alexandre Peltier, Roland van Velthoven
{"title":"The Single-Knot Running Vesicourethral Anastomosis after Minimally Invasive Prostatectomy: Review of the Technique and Its Modifications, Tips, and Pitfalls.","authors":"Simone Albisinni, Fouad Aoun, Alexandre Peltier, Roland van Velthoven","doi":"10.1155/2016/1481727","DOIUrl":"https://doi.org/10.1155/2016/1481727","url":null,"abstract":"<p><p>The vesicourethral anastomosis represents a step of major difficulty at the end of minimally invasive radical prostatectomy. Over 10 years ago, we have devised the single-knot running vesicourethral anastomosis, which has been widely adopted in urologic departments worldwide. Aim of the current paper is to review the technique, its adaptability in complex situations, its complications, and possible modifications, including the use of barbed sutures. </p>","PeriodicalId":20907,"journal":{"name":"Prostate Cancer","volume":"2016 ","pages":"1481727"},"PeriodicalIF":4.2,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/1481727","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34606504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Prostate CancerPub Date : 2016-01-01Epub Date: 2016-05-16DOI: 10.1155/2016/4754031
M Sean Peach, Daniel M Trifiletti, Bruce Libby
{"title":"Systematic Review of Focal Prostate Brachytherapy and the Future Implementation of Image-Guided Prostate HDR Brachytherapy Using MR-Ultrasound Fusion.","authors":"M Sean Peach, Daniel M Trifiletti, Bruce Libby","doi":"10.1155/2016/4754031","DOIUrl":"10.1155/2016/4754031","url":null,"abstract":"<p><p>Prostate cancer is the most common malignancy found in North American and European men and the second most common cause of cancer related death. Since the practice of PSA screening has become common the disease is most often found early and can have a long indolent course. Current definitive therapy treats the whole gland but has considerable long-term side effects. Focal therapies may be able to target the cancer while decreasing dose to organs at risk. Our objective was to determine if focal prostate brachytherapy could meet target objectives while permitting a decrease in dose to organs at risk in a way that would allow future salvage treatments. Further, we wanted to determine if focal treatment results in less toxicity. Utilizing the Medline repository, dosimetric papers comparing whole gland to partial gland brachytherapy and clinical papers that reported toxicity of focal brachytherapy were selected. A total of 9 dosimetric and 6 clinical papers met these inclusion criteria. Together, these manuscripts suggest that focal brachytherapy may be employed to decrease dose to organs at risk with decreased toxicity. Of current technology, image-guided HDR brachytherapy using MRI registered to transrectal ultrasound offers the flexibility and efficiency to achieve such focal treatments. </p>","PeriodicalId":20907,"journal":{"name":"Prostate Cancer","volume":"2016 ","pages":"4754031"},"PeriodicalIF":4.2,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4884850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34636610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Prostate CancerPub Date : 2016-01-01Epub Date: 2016-03-22DOI: 10.1155/2016/9561494
John M Lacy, William A Wilson, Raevti Bole, Li Chen, Ali S Meigooni, Randall G Rowland, William H St Clair
{"title":"Salvage Brachytherapy for Biochemically Recurrent Prostate Cancer following Primary Brachytherapy.","authors":"John M Lacy, William A Wilson, Raevti Bole, Li Chen, Ali S Meigooni, Randall G Rowland, William H St Clair","doi":"10.1155/2016/9561494","DOIUrl":"https://doi.org/10.1155/2016/9561494","url":null,"abstract":"<p><p>Purpose. In this study, we evaluated our experience with salvage brachytherapy after discovery of biochemical recurrence after a prior brachytherapy procedure. Methods and Materials. From 2001 through 2012 twenty-one patients treated by brachytherapy within University of Kentucky or from outside centers developed biochemical failure and had no evidence of metastases. Computed tomography (CT) scans were evaluated; patients who had an underseeded portion of their prostate were considered for reimplantation. Results. The majority of the patients in this study (61.9%) were low risk and median presalvage PSA was 3.49 (range 17.41-1.68). Mean follow-up was 61 months. At last follow-up after reseeding, 11/21 (52.4%) were free of biochemical recurrence. There was a trend towards decreased freedom from biochemical recurrence in low risk patients (p = 0.12). International Prostate Symptom Scores (IPSS) increased at 3-month follow-up visits but decreased and were equivalent to baseline scores at 18 months. Conclusions. Salvage brachytherapy after primary brachytherapy is possible; however, in our experience the side-effect profile after the second brachytherapy procedure was higher than after the first brachytherapy procedure. In this cohort of patients we demonstrate that approximately 50% oncologic control, low risk patients appear to have better outcomes than others. </p>","PeriodicalId":20907,"journal":{"name":"Prostate Cancer","volume":"2016 ","pages":"9561494"},"PeriodicalIF":4.2,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/9561494","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34413291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Prostate CancerPub Date : 2016-01-01Epub Date: 2016-07-25DOI: 10.1155/2016/3079684
Tarun Podder, Daniel Song, Timothy Showalter, Luc Beaulieu
{"title":"Advances in Radiotherapy for Prostate Cancer Treatment.","authors":"Tarun Podder, Daniel Song, Timothy Showalter, Luc Beaulieu","doi":"10.1155/2016/3079684","DOIUrl":"https://doi.org/10.1155/2016/3079684","url":null,"abstract":"Major categories of radiotherapy (RT) for prostate cancer (CaP) treatment are: (1) external beam RT (EBRT), and (2) brachytherapy (BT). EBRT are performed using different techniques like three-dimensional conformal RT (3D-CRT), intensity modulated RT (IMRT), volumetric modulated arc therapy (VMAT), and stereotactic body radiation therapy (SBRT), stereotactic radiosurgery (SRS) and intensity modulated proton therapy (IMPT), etc., using a variety of radiation delivery machines, such as a linear accelerator (Linac), Cyberknife robotic system, Gamma knife, Tomotherapy and proton beam machine. The primary advantage of proton beam therapy is sparing of normal tissues and organ at risks (OARs) with comparable coverage of the tumor volume. MR-Linac is the latest addition in the image-guided RT. Robot-assisted brachytherapy is one of the latest technological innovations in the field. With the advancement of technology, radiation therapy for prostate cancer can be improved using high quality multimodal imaging, robot-assistance for brachytherapy as well as EBRT. This chapter presents the advances in radiation therapy for the treatment of prostate cancer.","PeriodicalId":20907,"journal":{"name":"Prostate Cancer","volume":"2016 ","pages":"3079684"},"PeriodicalIF":4.2,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/3079684","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34307458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Prostate CancerPub Date : 2016-01-01Epub Date: 2016-05-16DOI: 10.1155/2016/3794738
Francis Ting, Pim J Van Leeuwen, James Thompson, Ron Shnier, Daniel Moses, Warick Delprado, Phillip D Stricker
{"title":"Assessment of the Performance of Magnetic Resonance Imaging/Ultrasound Fusion Guided Prostate Biopsy against a Combined Targeted Plus Systematic Biopsy Approach Using 24-Core Transperineal Template Saturation Mapping Prostate Biopsy.","authors":"Francis Ting, Pim J Van Leeuwen, James Thompson, Ron Shnier, Daniel Moses, Warick Delprado, Phillip D Stricker","doi":"10.1155/2016/3794738","DOIUrl":"https://doi.org/10.1155/2016/3794738","url":null,"abstract":"<p><p>Objective. To compare the performance of multiparametric resonance imaging/ultrasound fusion targeted biopsy (MRI/US-TBx) to a combined biopsy strategy (MRI/US-TBx plus 24-core transperineal template saturation mapping biopsy (TTMB)). Methods. Between May 2012 and October 2015, all patients undergoing MRI/US-TBx at our institution were included for analysis. Patients underwent MRI/US-TBx of suspicious lesions detected on multiparametric MRI +/- simultaneous TTMB. Subgroup analysis was performed on patients undergoing simultaneous MRI/US-TBx + TTMB. Primary outcome was PCa detection. Significant PCa was defined as ≥Gleason score (GS) 3 + 4 = 7 PCa. McNemar's test was used to compare detection rates between MRI/US-TBx and the combined biopsy strategy. Results. 148 patients underwent MRI/US-TBx and 80 patients underwent MRI/US-TBx + TTMB. In the MRI/US-TBx versus combined biopsy strategy subgroup analysis (n = 80), there were 55 PCa and 38 significant PCa. The detection rate for the combined biopsy strategy versus MRI/US-TBx for significant PCa was 49% versus 40% (p = 0.02) and for insignificant PCa was 20% versus 10% (p = 0.04), respectively. Eleven cases (14%) of significant PCa were detected exclusively on MRI/US-TBx and 7 cases (8.7%) of significant PCa were detected exclusively on TTMB. Conclusions. A combined biopsy approach (MRI/US-TBx + TTMB) detects more significant PCa than MRI/US-TBx alone; however, it will double the detection rate of insignificant PCa. </p>","PeriodicalId":20907,"journal":{"name":"Prostate Cancer","volume":"2016 ","pages":"3794738"},"PeriodicalIF":4.2,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/3794738","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34636609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Prostate CancerPub Date : 2016-01-01Epub Date: 2016-05-23DOI: 10.1155/2016/2420786
Aditya Juloori, Chirag Shah, Kevin Stephans, Andrew Vassil, Rahul Tendulkar
{"title":"Evolving Paradigm of Radiotherapy for High-Risk Prostate Cancer: Current Consensus and Continuing Controversies.","authors":"Aditya Juloori, Chirag Shah, Kevin Stephans, Andrew Vassil, Rahul Tendulkar","doi":"10.1155/2016/2420786","DOIUrl":"10.1155/2016/2420786","url":null,"abstract":"<p><p>High-risk prostate cancer is an aggressive form of the disease with an increased risk of distant metastasis and subsequent mortality. Multiple randomized trials have established that the combination of radiation therapy and long-term androgen deprivation therapy improves overall survival compared to either treatment alone. Standard of care for men with high-risk prostate cancer in the modern setting is dose-escalated radiotherapy along with 2-3 years of androgen deprivation therapy (ADT). There are research efforts directed towards assessing the efficacy of shorter ADT duration. Current research has been focused on assessing hypofractionated and stereotactic body radiation therapy (SBRT) techniques. Ongoing randomized trials will help assess the utility of pelvic lymph node irradiation. Research is also focused on multimodality therapy with addition of a brachytherapy boost to external beam radiation to help improve outcomes in men with high-risk prostate cancer. </p>","PeriodicalId":20907,"journal":{"name":"Prostate Cancer","volume":"2016 ","pages":"2420786"},"PeriodicalIF":4.2,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4893567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34587616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Prostate CancerPub Date : 2016-01-01Epub Date: 2016-04-11DOI: 10.1155/2016/7105678
Pim J van Leeuwen, Amila Siriwardana, Monique Roobol, Francis Ting, Daan Nieboer, James Thompson, Warick Delprado, Anne-Marie Haynes, Phillip Brenner, Phillip Stricker
{"title":"Predicting Low-Risk Prostate Cancer from Transperineal Saturation Biopsies.","authors":"Pim J van Leeuwen, Amila Siriwardana, Monique Roobol, Francis Ting, Daan Nieboer, James Thompson, Warick Delprado, Anne-Marie Haynes, Phillip Brenner, Phillip Stricker","doi":"10.1155/2016/7105678","DOIUrl":"https://doi.org/10.1155/2016/7105678","url":null,"abstract":"<p><p>Introduction. To assess the performance of five previously described clinicopathological definitions of low-risk prostate cancer (PC). Materials and Methods. Men who underwent radical prostatectomy (RP) for clinical stage ≤T2, PSA <10 ng/mL, Gleason score <8 PC, diagnosed by transperineal template-guided saturation biopsy were included. The performance of five previously described criteria (i.e., criteria 1-5, criterion 1 stringent (Gleason score 6 + ≤5 mm total max core length PC + ≤3 mm max per core length PC) up to criterion 5 less stringent (Gleason score 6-7 with ≤5% Gleason grade 4) was analysed to assess ability of each to predict insignificant disease in RP specimens (defined as Gleason score ≤6 and total tumour volume <2.5 mL, or Gleason score 7 with ≤5% grade 4 and total tumour volume <0.7 mL). Results. 994 men who underwent RP were included. Criterion 4 (Gleason score 6) performed best with area under the curve of receiver operating characteristics 0.792. At decision curve analysis, criterion 4 was deemed clinically the best performing transperineal saturation biopsy-based definition for low-risk PC. Conclusions. Gleason score 6 disease demonstrated a superior trade-off between sensitivity and specificity for clarifying low-risk PC that can guide treatment and be used as reference test in diagnostic studies. </p>","PeriodicalId":20907,"journal":{"name":"Prostate Cancer","volume":"2016 ","pages":"7105678"},"PeriodicalIF":4.2,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2016/7105678","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34458293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}