Journal article
Evaluating 4Kscore's role in predicting progression on active surveillance for prostate cancer independently of clinical information and PIRADS score
Prostate cancer and prostatic diseases, Vol.28(1), pp.180-186
03/2025
DOI: 10.1038/s41391-024-00898-w
PMID: 39333697
Abstract
4Kscore is used to aid the decision for prostate biopsy, however its role in active surveillance (AS) has not been investigated in a magnetic resonance imaging (MRI)-based protocol. Our objective was to assess the association between 4Kscore and progression in men undergoing AS on a prospective MRI-based protocol.
This was a single-institution, single-arm, non-therapeutic, interventional trial of 166 men with biopsy-confirmed prostate cancer enrolled between 2014-2020. Patients were placed on a trial-mandated AS protocol including yearly multiparametric (mp)MRI, prostate biopsy, and 4Kscore followed for 48 months after diagnosis. We analyzed protocol-defined and grade progression at confirmatory and subsequent surveillance biopsies.
Out of 166 patients, 83 (50%) men progressed per protocol and of them 41 (24.7% of whole cohort) progressed by grade. At confirmatory biopsy, men with a baseline 4Kscore ≥ 20% had a higher risk of grade progression compared to those with 4Kscore < 20% (OR = 4.04, 95% CI: 1.05-15.59, p = 0.043) after adjusting for National Comprehensive Cancer Network (NCCN) risk and baseline PIRADS score. At surveillance biopsies, most recent 4Kscore ≥ 20% significantly predicted per protocol (OR = 2.61, 95% CI: 1.03-6.63, p = 0.044) and grade progression (OR = 5.13, 95% CI: 1.63-16.11, p = 0.005).
For patients on AS, baseline 4Kscore predicted grade progression at confirmatory biopsy, and most recent 4Kscore predicted per-protocol and grade progression at surveillance biopsy.
Details
- Title: Subtitle
- Evaluating 4Kscore's role in predicting progression on active surveillance for prostate cancer independently of clinical information and PIRADS score
- Creators
- Helen Y Hougen - University of IowaIsildinha M Reis - University of MiamiSunwoo Han - University of MiamiNachiketh Soodana Prakash - University of MiamiJamie Thomas - University of MiamiRadka Stoyanova - University of MiamiR Patricia Castillo - University of MiamiOleksandr N Kryvenko - University of MiamiChad R Ritch - University of MiamiBruno Nahar - University of MiamiMark L Gonzalgo - University of MiamiSandra M Gaston - University of MiamiMatthew C Abramowitz - University of MiamiAlan Dal Pra - University of MiamiBrandon A Mahal - University of MiamiAlan Pollack - University of MiamiDipen J Parekh - University of MiamiSanoj Punnen - University of Miami
- Resource Type
- Journal article
- Publication Details
- Prostate cancer and prostatic diseases, Vol.28(1), pp.180-186
- Publisher
- SPRINGERNATURE
- DOI
- 10.1038/s41391-024-00898-w
- PMID
- 39333697
- ISSN
- 1365-7852
- eISSN
- 1476-5608
- Grant note
- U01CA239141 / U.S. Department of Health & Human Services | NIH | National Cancer Institute (NCI) 1R01CA272766 / U.S. Department of Health & Human Services | NIH | National Cancer Institute (NCI) P30CA240139 / U.S. Department of Health & Human Services | NIH | National Cancer Institute (NCI)
- Language
- English
- Electronic publication date
- 09/27/2024
- Date published
- 03/2025
- Academic Unit
- Urology
- Record Identifier
- 9984721237502771
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