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Clinical and Genomic Characterization of Low–Prostate-specific Antigen, High-grade Prostate Cancer

Overview of attention for article published in European Urology, February 2018
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (95th percentile)
  • High Attention Score compared to outputs of the same age and source (84th percentile)

Mentioned by

twitter
82 tweeters
facebook
3 Facebook pages

Citations

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4 Dimensions

Readers on

mendeley
15 Mendeley
Title
Clinical and Genomic Characterization of Low–Prostate-specific Antigen, High-grade Prostate Cancer
Published in
European Urology, February 2018
DOI 10.1016/j.eururo.2018.01.043
Pubmed ID
Authors

Brandon A. Mahal, David D. Yang, Natalie Q. Wang, Mohammed Alshalalfa, Elai Davicioni, Voleak Choeurng, Edward M. Schaeffer, Ashley E. Ross, Daniel E. Spratt, Robert B. Den, Neil E. Martin, Kent W. Mouw, Peter F. Orio, Toni K. Choueiri, Mary-Ellen Taplin, Quoc-Dien Trinh, Felix Y. Feng, Paul L. Nguyen

Abstract

The consequences of low prostate-specific antigen (PSA) in high-grade (Gleason 8-10) prostate cancer are unknown. To evaluate the clinical implications and genomic features of low-PSA, high-grade disease. This was a retrospective study of clinical data for 494 793 patients from the National Cancer Data Base and 136 113 patients from the Surveillance, Epidemiology, and End Results program with cT1-4N0M0 prostate cancer (median follow-up 48.9 and 25.0 mo, respectively), and genomic data for 4960 patients from the Decipher Genomic Resource Information Database. Data were collected for 2004-2017. Multivariable Fine-Gray and Cox regressions were used to analyze prostate cancer-specific mortality (PCSM) and all-cause mortality, respectively. For Gleason 8-10 disease, using PSA 4.1-10.0ng/ml (n=38 719) as referent, the distribution of PCSM by PSA was U-shaped, with an adjusted hazard ratio (AHR) of 2.70 for PSA ≤2.5ng/ml (n=3862, p<0.001) versus 1.97, 1.36, and 2.56 for PSA of 2.6-4.0 (n=4199), 10.1-20.0 (n=17 372), and >20.0ng/ml (n=16 114), respectively. By contrast, the distribution of PCSM by PSA was linear for Gleason ≤7 (using PSA 4.1-10.0ng/ml as the referent, n=359 898), with an AHR of 0.41 (p=0.13) for PSA ≤2.5ng/ml (n=37 812) versus 1.38, 2.28, and 4.61 for PSA of 2.6-4.0 (n=54 152), 10.1-20.0 (n=63 319), and >20.0ng/ml (n=35 459), respectively (pinteraction<0.001). Gleason 8-10, PSA ≤2.5ng/ml disease had a significantly higher PCSM than standard high-risk/very high-risk disease with PSA >2.5ng/ml (AHR 2.15, p=0.002; 47-mo PCSM 14% vs 4.9%). Among Gleason 8-10 patients treated with radiotherapy, androgen deprivation therapy was associated with a survival benefit for PSA >2.5ng/ml (AHR 0.87; p<0.001) but not ≤2.5ng/ml (AHR 1.36; p=0.084; pinteraction=0.021). For Gleason 8-10 tumors, PSA ≤2.5ng/ml was associated with higher expression of neuroendocrine/small-cell markers compared to >2.5ng/ml (p=0.046), with no such relationship for Gleason ≤7 disease. Low-PSA, high-grade prostate cancer has very high risk for PCSM, potentially responds poorly to androgen deprivation therapy, and is associated with neuroendocrine genomic features. In this study, we found that low-prostate-specific antigen, high-grade prostate cancer has a very high risk for prostate cancer death, may not respond well to androgen deprivation therapy, and is associated with neuroendocrine genomic features. These findings suggest that current nomograms and treatment paradigms may need modification.

Twitter Demographics

The data shown below were collected from the profiles of 82 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 15 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 15 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 7 47%
Other 3 20%
Student > Bachelor 1 7%
Professor 1 7%
Student > Ph. D. Student 1 7%
Other 2 13%
Readers by discipline Count As %
Medicine and Dentistry 8 53%
Biochemistry, Genetics and Molecular Biology 3 20%
Unspecified 3 20%
Immunology and Microbiology 1 7%

Attention Score in Context

This research output has an Altmetric Attention Score of 56. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 25 July 2018.
All research outputs
#244,569
of 11,895,307 outputs
Outputs from European Urology
#153
of 3,737 outputs
Outputs of similar age
#13,015
of 270,806 outputs
Outputs of similar age from European Urology
#14
of 91 outputs
Altmetric has tracked 11,895,307 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 97th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 3,737 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 12.5. This one has done particularly well, scoring higher than 95% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 270,806 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 95% of its contemporaries.
We're also able to compare this research output to 91 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 84% of its contemporaries.