PCA3 appears to predict risk for extracapsular extension

According to an article by Whitman et al., so far only pre-published on line, the PCA3 urine test is capable of predicting risk for extracapsular extension in men with prostate cancer prior to radical prostatectomy.

If the results of this study can be replicated, this is an important finding that may significantly affect treatment for many men. It should be noted that the current study was conducted by the Center for Prostate Disease Research in conjunction with the developer of the specific test, which makes independent replication of the results particularly important.

In the study, post-DRE urine specimens were obtained from 72 men with prostate cancer prior to radical prostatectomy. PCA3 and PSA mRNA levels were measured. The ratio of PCA3 to PSA mRNA was recorded as a PCA3 score and correlated with data from each prostate specimen post-surgery.

The authors found that patients with extracapsular extension had a significantly higher median PCA3 score than patients without extracapsular extension (48.8 vs 18.7). On multivariate analysis, they found that a patient’s PCA3 score was an independent predictor of extracapsular extension (p = 0.01) and was capable of predicting extracapsular extension with 94 percent specificity and an 80 percent positive predictive value.

The authors state that, to their knowledge (and to ours), “this is the first report of a molecular urine assay that predicts extracapsular extension.”

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