We report a 5-year follow-up of a cohort of patients who underwent a first prostate biopsy following a prostate cancer antigen 3 (PCA3) test.
We reviewed consecutive patients who had in 2008 a single urinary PCA3 test using the Gen-Probe® assay before a first prostate biopsy for a prostate-specific antigen (PSA) between 3 and 20ng/mL and/or a suspicious digital rectal examination. PCA3 performances were analyzed in 2008 and then in 2013 after taking into account the results of repeat biopsies.
At initial biopsy in 2008, among the 125 patients study cohort, prostate cancer was diagnosed in 47 patients (37.6%). Abnormal digital rectal exam, PSA density, prostate volume and PCA3 score were significantly associated with prostate cancer diagnosis. PCA3 area under the curve of the receiver operating curve was 0.67 [95%CI: 0.57-0.76] with an optimal threshold of PCA3 in this sample of 24 units. During the 5-year follow-up, among the 78 patients with a negative prostate biopsy in 2008, 23 (29.5%) had a repeat prostate biopsy of whom 14 were diagnosed with prostate cancer. PCA3 score measured in 2008 was associated with prostate cancer diagnosis (P=0.002). All 9 patients with a negative repeat prostate biopsy had a PCA3 score below the cut-off while this was the case in only 2 patients among the 14 with a positive repeat prostate biopsy.
The results of a single PCA3 test before a first prostate biopsy seems to be a useful aid in deciding whether to perform a repeat biopsy.
Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie. 2017 Apr 03 [Epub]
S Bernardeau, T Charles, G Fromont-Hankard, J Irani
Service de chirurgie urologique et de transplantation rénale, centre hospitalo-universitaire de Poitiers, 86000 Poitiers, France. Electronic address: ., Service de chirurgie urologique et de transplantation rénale, centre hospitalo-universitaire de Poitiers, 86000 Poitiers, France., Service d'anatomie et cytologie pathologiques, centre hospitalo-universitaire Bretonneau, 37000 Tours, France., Service de chirurgie urologique, centre hospitalo-universitaire du Kremlin-Bicêtre, AP-HP, 94270 Paris, France.