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Prognostic value of urinary prostate cancer antigen 3 (PCA3) during active surveillance of patients with low‐risk prostate cancer receiving 5α‐reductase inhibitors
Author(s) -
Fradet Vincent,
Toren Paul,
NguileMakao Molière,
Lodde Michele,
Lévesque Jérome,
Léger Caroline,
Caron André,
Bergeron Alain,
BenZvi Tal,
Lacombe Louis,
Pouliot Frédéric,
Tiguert Rabi,
Dujardin Thierry,
Fradet Yves
Publication year - 2018
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.14041
Subject(s) - medicine , prostate cancer , rectal examination , pca3 , prostate , prostate specific antigen , gynecology , prostate biopsy , cancer , urology , oncology
Objectives To determine the clinical performance of the urinary prostate cancer antigen 3 ( PCA 3) test to predict the risk of Gleason grade re‐classification amongst men receiving a 5α‐reductase inhibitor (5 ARI ) during active surveillance ( AS ) for prostate cancer. Patients and Methods Patients with low‐risk prostate cancer were enrolled in a prospective Phase II study of AS complemented with prescription of a 5 ARI . A repeat biopsy was taken within the first year and annually according to physician and patient preference. In all, 90 patients had urine collected after digital rectal examination of the prostate before the first repeat biopsy. The PCA 3 test was performed in a blinded manner at a central laboratory. Results Using a PCA 3‐test score threshold of 35, there was a significant difference ( P < 0.001) in the risk of being diagnosed with Gleason ≥7 cancer during a median of 7 years of follow‐up. Adjusted Cox regression and Kaplan–Meier analyses also showed a significantly higher risk of upgrading to Gleason ≥7 during follow‐up for those with a higher PCA 3‐test score. Conclusion The urinary PCA 3 test predicted Gleason grade re‐classification amongst patients receiving a 5 ARI during AS for low‐risk prostate cancer.