EAU 2011 - The PCA3 score accurately predicts tumor volume and might help in selecting prostate cancer patients for active surveillance - Session Highlights

VIENNA, AUSTRIA (UroToday.com) - The objective of this study was to assess PCA3 as an additional criterion to select patients with prostate cancer (CaP) for active surveillance (AS).

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


The opinions expressed in this article are those of the UroToday.com Contributing Medical Editor and do not necessarily reflect the viewpoints of the European Association of Urology (EAU)


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