Their study cohort consisted of 106 consecutive low-risk CaP patients with the following data; PSA <10 ng/ml, clinical stage T1c-T2a and biopsy Gleason score <6). All had a PCA3 urine test prior to undergoing radical prostatectomy (RP). They assessed the performance of biopsy criteria, PCA3 score, PSA density and MRI findings in predicting the following 4 prognostic pathologic findings in RP specimens; pT3-pT4 disease, unfavorable disease defined by a pT3-4 disease and/or a pathological primary Gleason pattern 4, tumor volume <0.5 cm3, insignificant CaP.
The PCA3 score strongly correlated with tumor volume in a linear regression analysis (p<0.001, r=0.409). The risk of having a CaP tumor ≥0.5 cm3 and significant CaP was increased 3-fold in men with a PCA3 ≥25 compared with men with a PCA3 <5 when used with most AS biopsy criteria. A trend towards higher PCA3 scores in patients with unfavorable and non organ-confined disease and Gleason>6 cancers were noted. In a multivariate analysis taking into account each AS criterion, the PCA3 score was an important predictive factor for a tumor volume <0.5 cm3 (OR 5.4; p=0.010) and insignificant CaP (OR 12.7; p=0.003). Biopsy criteria and MRI findings were significantly associated with overall unfavorable disease (OR 3.9 and 5.0; p=0.030 and 0.025, respectively).
Presented by Guillaume Ploussard, MD, et al. at the 26th Annual European Association of Urology (EAU) Congress - March 18 - 21, 2011 - Austria Centre Vienna, Vienna, Austria