Abstract
BACKGROUND: Prostate cancer overdiagnosis and overtreatment represents a major problem. Many men with low-grade disease on biopsy are undergraded and they harbour high-grade disease at prostatectomy with no reliable way to identify these men. We used a novel urine-based 2-gene methylation test to identify prostate cancers with aggressive features.
METHODS: Following a proof of concept study in 100 post-radical prostatectomy tissue samples, urine samples were tested from 665 men at multiple U.S. centers undergoing prostate needle biopsy for elevated prostate-specific antigen (2-10 ng ml(-1)). A prediction model was then developed from a combination of clinical factors and the urine-based markers. It was then prospectively tested for accurate prediction of adverse disease (surgical Gleason score ⩾7 and/or a pathological stage ⩾T3a) using urine from a separate cohort of 96 men before radical prostatectomy.
RESULTS: Among pre-prostatectomy men with a biopsy Gleason score <7, 41% had adverse disease of which 100% were correctly identified by the test with a negative predictive value of 100% (95% confidence interval, 86-100%).
CONCLUSIONS: This urine-based test accurately identifies men with clinical low-risk disease who do not have adverse pathology in their prostates and would be excellent candidates for active surveillance.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 802-808 |
| Number of pages | 7 |
| Journal | British Journal of Cancer |
| Volume | 112 |
| Issue number | 5 |
| DOIs | |
| State | Published - Mar 3 2015 |
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ASJC Scopus subject areas
- Medicine(all)
Cite this
A urine-based methylation signature for risk stratification within low-risk prostate cancer. / Jatkoe, T. A.; Karnes, Robert Jeffrey; Freedland, S. J.; Wang, Y.; Le, A.; Baden, J.
In: British Journal of Cancer, Vol. 112, No. 5, 03.03.2015, p. 802-808.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A urine-based methylation signature for risk stratification within low-risk prostate cancer
AU - Jatkoe, T. A.
AU - Karnes, Robert Jeffrey
AU - Freedland, S. J.
AU - Wang, Y.
AU - Le, A.
AU - Baden, J.
PY - 2015/3/3
Y1 - 2015/3/3
N2 - BACKGROUND: Prostate cancer overdiagnosis and overtreatment represents a major problem. Many men with low-grade disease on biopsy are undergraded and they harbour high-grade disease at prostatectomy with no reliable way to identify these men. We used a novel urine-based 2-gene methylation test to identify prostate cancers with aggressive features.METHODS: Following a proof of concept study in 100 post-radical prostatectomy tissue samples, urine samples were tested from 665 men at multiple U.S. centers undergoing prostate needle biopsy for elevated prostate-specific antigen (2-10 ng ml(-1)). A prediction model was then developed from a combination of clinical factors and the urine-based markers. It was then prospectively tested for accurate prediction of adverse disease (surgical Gleason score ⩾7 and/or a pathological stage ⩾T3a) using urine from a separate cohort of 96 men before radical prostatectomy.RESULTS: Among pre-prostatectomy men with a biopsy Gleason score <7, 41% had adverse disease of which 100% were correctly identified by the test with a negative predictive value of 100% (95% confidence interval, 86-100%).CONCLUSIONS: This urine-based test accurately identifies men with clinical low-risk disease who do not have adverse pathology in their prostates and would be excellent candidates for active surveillance.
AB - BACKGROUND: Prostate cancer overdiagnosis and overtreatment represents a major problem. Many men with low-grade disease on biopsy are undergraded and they harbour high-grade disease at prostatectomy with no reliable way to identify these men. We used a novel urine-based 2-gene methylation test to identify prostate cancers with aggressive features.METHODS: Following a proof of concept study in 100 post-radical prostatectomy tissue samples, urine samples were tested from 665 men at multiple U.S. centers undergoing prostate needle biopsy for elevated prostate-specific antigen (2-10 ng ml(-1)). A prediction model was then developed from a combination of clinical factors and the urine-based markers. It was then prospectively tested for accurate prediction of adverse disease (surgical Gleason score ⩾7 and/or a pathological stage ⩾T3a) using urine from a separate cohort of 96 men before radical prostatectomy.RESULTS: Among pre-prostatectomy men with a biopsy Gleason score <7, 41% had adverse disease of which 100% were correctly identified by the test with a negative predictive value of 100% (95% confidence interval, 86-100%).CONCLUSIONS: This urine-based test accurately identifies men with clinical low-risk disease who do not have adverse pathology in their prostates and would be excellent candidates for active surveillance.
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UR - http://www.scopus.com/inward/citedby.url?scp=84928696411&partnerID=8YFLogxK
U2 - 10.1038/bjc.2015.7
DO - 10.1038/bjc.2015.7
M3 - Article
C2 - 25695483
AN - SCOPUS:84928696411
VL - 112
SP - 802
EP - 808
JO - British Journal of Cancer
JF - British Journal of Cancer
SN - 0007-0920
IS - 5
ER -