Understanding PSA and its derivatives in prediction of tumor volume: Addressing health disparities in prostate cancer risk stratification

Felix M. Chinea, Kirill Lyapichev, Jonathan I. Epstein, Deukwoo Kwon, Paul Taylor Smith, Alan Pollack, Richard J Cote, Oleksandr Kryvenko

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objectives: To address health disparities in risk stratification of U.S. Hispanic/ Latino men by characterizing influences of prostate weight, body mass index, and race/ethnicity on the correlation of PSA derivatives with Gleason score 6 (Grade Group 1) tumor volume in a diverse cohort. Results: Using published PSA density and PSA mass density cutoff values, men with higher body mass indices and prostate weights were less likely to have a tumor volume < 0.5 cm3. Variability across race/ethnicity was found in the univariable analysis for all PSA derivatives when predicting for tumor volume. In receiver operator characteristic analysis, area under the curve values for all PSA derivatives varied across race/ethnicity with lower optimal cutoff values for Hispanic/Latino (PSA=2.79, PSA density=0.06, PSA mass=0.37, PSA mass density=0.011) and Non-Hispanic Black (PSA=3.75, PSA density=0.07, PSA mass=0.46, PSA mass density=0.008) compared to Non-Hispanic White men (PSA=4.20, PSA density=0.11 PSA mass=0.53, PSA mass density=0.014). Materials and Methods: We retrospectively analyzed 589 patients with lowrisk prostate cancer at radical prostatectomy. Pre-operative PSA, patient height, body weight, and prostate weight were used to calculate all PSA derivatives. Receiver operating characteristic curves were constructed for each PSA derivative per racial/ethnic group to establish optimal cutoff values predicting for tumor volume ≥0.5 cm3. Conclusions: Increasing prostate weight and body mass index negatively influence PSA derivatives for predicting tumor volume. PSA derivatives' ability to predict tumor volume varies significantly across race/ethnicity. Hispanic/Latino and Non-Hispanic Black men have lower optimal cutoff values for all PSA derivatives, which may impact risk assessment for prostate cancer.

Original languageEnglish (US)
Pages (from-to)20802-20812
Number of pages11
JournalOncotarget
Volume8
Issue number13
DOIs
StatePublished - 2017

Fingerprint

Tumor Burden
Hispanic Americans
Prostatic Neoplasms
Prostate
Health
Weights and Measures
Body Mass Index
Neoplasm Grading
Prostatectomy
Ethnic Groups
ROC Curve
Area Under Curve
Body Weight

Keywords

  • Health disparities
  • Hispanic/Latino
  • Prostate cancer
  • Prostate specific antigen
  • Risk stratification

ASJC Scopus subject areas

  • Oncology

Cite this

Understanding PSA and its derivatives in prediction of tumor volume : Addressing health disparities in prostate cancer risk stratification. / Chinea, Felix M.; Lyapichev, Kirill; Epstein, Jonathan I.; Kwon, Deukwoo; Smith, Paul Taylor; Pollack, Alan; Cote, Richard J; Kryvenko, Oleksandr.

In: Oncotarget, Vol. 8, No. 13, 2017, p. 20802-20812.

Research output: Contribution to journalArticle

Chinea, Felix M. ; Lyapichev, Kirill ; Epstein, Jonathan I. ; Kwon, Deukwoo ; Smith, Paul Taylor ; Pollack, Alan ; Cote, Richard J ; Kryvenko, Oleksandr. / Understanding PSA and its derivatives in prediction of tumor volume : Addressing health disparities in prostate cancer risk stratification. In: Oncotarget. 2017 ; Vol. 8, No. 13. pp. 20802-20812.
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T1 - Understanding PSA and its derivatives in prediction of tumor volume

T2 - Addressing health disparities in prostate cancer risk stratification

AU - Chinea, Felix M.

AU - Lyapichev, Kirill

AU - Epstein, Jonathan I.

AU - Kwon, Deukwoo

AU - Smith, Paul Taylor

AU - Pollack, Alan

AU - Cote, Richard J

AU - Kryvenko, Oleksandr

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N2 - Objectives: To address health disparities in risk stratification of U.S. Hispanic/ Latino men by characterizing influences of prostate weight, body mass index, and race/ethnicity on the correlation of PSA derivatives with Gleason score 6 (Grade Group 1) tumor volume in a diverse cohort. Results: Using published PSA density and PSA mass density cutoff values, men with higher body mass indices and prostate weights were less likely to have a tumor volume < 0.5 cm3. Variability across race/ethnicity was found in the univariable analysis for all PSA derivatives when predicting for tumor volume. In receiver operator characteristic analysis, area under the curve values for all PSA derivatives varied across race/ethnicity with lower optimal cutoff values for Hispanic/Latino (PSA=2.79, PSA density=0.06, PSA mass=0.37, PSA mass density=0.011) and Non-Hispanic Black (PSA=3.75, PSA density=0.07, PSA mass=0.46, PSA mass density=0.008) compared to Non-Hispanic White men (PSA=4.20, PSA density=0.11 PSA mass=0.53, PSA mass density=0.014). Materials and Methods: We retrospectively analyzed 589 patients with lowrisk prostate cancer at radical prostatectomy. Pre-operative PSA, patient height, body weight, and prostate weight were used to calculate all PSA derivatives. Receiver operating characteristic curves were constructed for each PSA derivative per racial/ethnic group to establish optimal cutoff values predicting for tumor volume ≥0.5 cm3. Conclusions: Increasing prostate weight and body mass index negatively influence PSA derivatives for predicting tumor volume. PSA derivatives' ability to predict tumor volume varies significantly across race/ethnicity. Hispanic/Latino and Non-Hispanic Black men have lower optimal cutoff values for all PSA derivatives, which may impact risk assessment for prostate cancer.

AB - Objectives: To address health disparities in risk stratification of U.S. Hispanic/ Latino men by characterizing influences of prostate weight, body mass index, and race/ethnicity on the correlation of PSA derivatives with Gleason score 6 (Grade Group 1) tumor volume in a diverse cohort. Results: Using published PSA density and PSA mass density cutoff values, men with higher body mass indices and prostate weights were less likely to have a tumor volume < 0.5 cm3. Variability across race/ethnicity was found in the univariable analysis for all PSA derivatives when predicting for tumor volume. In receiver operator characteristic analysis, area under the curve values for all PSA derivatives varied across race/ethnicity with lower optimal cutoff values for Hispanic/Latino (PSA=2.79, PSA density=0.06, PSA mass=0.37, PSA mass density=0.011) and Non-Hispanic Black (PSA=3.75, PSA density=0.07, PSA mass=0.46, PSA mass density=0.008) compared to Non-Hispanic White men (PSA=4.20, PSA density=0.11 PSA mass=0.53, PSA mass density=0.014). Materials and Methods: We retrospectively analyzed 589 patients with lowrisk prostate cancer at radical prostatectomy. Pre-operative PSA, patient height, body weight, and prostate weight were used to calculate all PSA derivatives. Receiver operating characteristic curves were constructed for each PSA derivative per racial/ethnic group to establish optimal cutoff values predicting for tumor volume ≥0.5 cm3. Conclusions: Increasing prostate weight and body mass index negatively influence PSA derivatives for predicting tumor volume. PSA derivatives' ability to predict tumor volume varies significantly across race/ethnicity. Hispanic/Latino and Non-Hispanic Black men have lower optimal cutoff values for all PSA derivatives, which may impact risk assessment for prostate cancer.

KW - Health disparities

KW - Hispanic/Latino

KW - Prostate cancer

KW - Prostate specific antigen

KW - Risk stratification

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