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Diagnosis and precise risk stratification of prostate cancer is essential for individualized treatment decisions.
Therefore, better stratification of prostate cancer patients with respect to clinical decision-making is necessary, especially in the predominant group of low- to intermediate-risk prostate cancers.
Identification of complex gene-signatures is a recent and promising tool in stratification of prostate cancer patients, though still costly and not easily applicable in daily practice.
Molecular biomarkers such as gene signatures have shown promising results in risk stratification of prostate cancer patients (Sartori and Chan, 2014), but the current knowledge of gene expression in hypoxic prostate tumours is scarce.
The use of combined MRI/MRSI is generally considered to improve the specificity of prostate cancer detection and it may also be useful for risk stratification of prostate cancers.
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In recent years, multi-parametric prostate MRI (mpMRI) has emerged as a useful tool for the detection and risk stratification of primary prostate cancer and recently has been incorporated into American Urological Association (AUA) algorithms for patients with suspected or low-risk prostate cancer [8 10].
These outcomes are important because accurate risk stratification of primary prostate cancer historically has been fraught with overdiagnosis and overtreatment [14 16].
There is thus a real clinical need for new biomarkers that allow for the early detection of high-risk prostate cancer, which would assist in risk stratification and prognostication of prostate cancer patients.
Joniau, S. et al. Stratification of high-risk prostate cancer into prognostic categories: a European multi-institutional study.
Although the primary cutoff point (1.15 ng/mL) significantly distinguished the localized untreated patients from the control group, plasma Hsp70 levels did not prove more effective than PSA as a predictor for diagnosis or stratification of patients with prostate cancer in the context of group comparisons.
In this study, we hypothesize that multiple TMPRSS2 ERG fusion subtypes and additional low-prevalent TMPRSS2 ETS fusion genes are collectively more informative than any single marker alone in the noninvasive detection and stratification of clinically significant prostate cancer.
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