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- Title
Independent validation of a pre-specified four-kallikrein marker model for prediction of adverse pathology and biochemical recurrence.
- Authors
Rasmussen, Martin; Fredsøe, Jacob; Tin, Amy L; Vickers, Andrew J; Ulhøi, Benedicte; Borre, Michael; Eastham, James; Ehdaie, Behfar; Guillonneau, Bertrand; Laudone, Vincent; Scardino, Peter T; Touijer, Karim; Sørensen, Karina D; Lilja, Hans
- Abstract
<bold>Background: </bold>Accurate markers for prostate cancer (PC) risk stratification could aid decision-making for initial management strategies. The 4Kscore has an undefined role in predicting outcomes after radical prostatectomy (RP).<bold>Methods: </bold>We included 1476 patients with 4Kscore measured prior to RP at two institutions. The 4Kscore was assessed for prediction of adverse pathology at RP and biochemical recurrence (BCR) relative to a clinical model. We pre-specified that all analyses would be assessed in biopsy Grade Group 1 (GG1) or 2 (GG2) PC patients, separately.<bold>Results: </bold>The 4Kscore increased discrimination for adverse pathology in all patients (delta area under the receiver operative curve (AUC) 0.009, 95% confidence interval (CI) 0.002, 0.016; clinical model AUC 0.767), driven by GG1 (delta AUC 0.040, 95% CI 0.006, 0.073) rather than GG2 patients (delta AUC 0.005, 95% CI -0.012, 0.021). Adding 4Kscore improved prediction of BCR in all patients (delta C-index 0.014, 95% CI 0.007, 0.021; preop-BCR nomogram C-index 0.738), again with larger changes in GG1 than in GG2.<bold>Conclusions: </bold>This study validates prior investigations on the use of 4Kscore in men with biopsy-confirmed PC. Men with GG1 PC and a high 4Kscore may benefit from additional testing to guide treatment selection. Further research is warranted regarding the value of the 4Kscore in men with biopsy GG2 PC.
- Subjects
PROSTATECTOMY; PROSTATE; RESEARCH funding; BLOOD coagulation factors; PROSTATE-specific antigen; PROSTATE tumors; TUMOR grading
- Publication
British Journal of Cancer, 2022, Vol 126, Issue 6, p1004
- ISSN
0007-0920
- Publication type
journal article
- DOI
10.1038/s41416-021-01661-x