PURPOSE: Many patients who undergo surgery or radiation therapy to treat localized prostate cancer experience an increase in serum prostate specific antigen (PSA) after treatment. This study documents patterns of PSA recurrence after surgery or radiation to treat localized prostate cancer and quantifies the extent to which an increasing PSA predicts death from prostate cancer. MATERIALS AND METHODS: Posttreatment PSA levels were measured on a population based cohort of 1136 men diagnosed with localized prostate cancer in community practice in Connecticut between 1990 and 1992, and treated within 6 months of diagnosis with surgery or radiation with or without androgen withdrawal therapy. The major outcome measure was death from prostate cancer. RESULTS: PSA recurrence followed a log-linear pattern over time. Patients who died of prostate cancer had a median PSA doubling time of 0.8 years (25th and 75th percentiles 0.5 to 1.4 years). Patients who did not die of prostate cancer within 10 years of diagnosis had either no posttreatment increase in serum PSA (40%) or had a PSA doubling time longer than 1 year (44%). CONCLUSIONS: Patients whose posttreatment PSA doubling times before the initiation of androgen withdrawal therapy are less than 1 year are at high risk of dying of prostate cancer within 10 years of diagnosis. Men with PSA recurrences that are doubling at rates greater than 1 year are at low risk of death from prostate cancer within 10 years of diagnosis.
PURPOSE: Many patients who undergo surgery or radiation therapy to treat localized prostate cancer experience an increase in serum prostate specific antigen (PSA) after treatment. This study documents patterns of PSA recurrence after surgery or radiation to treat localized prostate cancer and quantifies the extent to which an increasing PSA predicts death from prostate cancer. MATERIALS AND METHODS: Posttreatment PSA levels were measured on a population based cohort of 1136 men diagnosed with localized prostate cancer in community practice in Connecticut between 1990 and 1992, and treated within 6 months of diagnosis with surgery or radiation with or without androgen withdrawal therapy. The major outcome measure was death from prostate cancer. RESULTS:PSA recurrence followed a log-linear pattern over time. Patients who died of prostate cancer had a median PSA doubling time of 0.8 years (25th and 75th percentiles 0.5 to 1.4 years). Patients who did not die of prostate cancer within 10 years of diagnosis had either no posttreatment increase in serum PSA (40%) or had a PSA doubling time longer than 1 year (44%). CONCLUSIONS:Patients whose posttreatment PSA doubling times before the initiation of androgen withdrawal therapy are less than 1 year are at high risk of dying of prostate cancer within 10 years of diagnosis. Men with PSA recurrences that are doubling at rates greater than 1 year are at low risk of death from prostate cancer within 10 years of diagnosis.
Authors: Verane Achard; Giorgio Lamanna; Antoine Denis; Thomas De Perrot; Ismini Charis Mainta; Osman Ratib; Christophe Iselin; Raymond Miralbell; Valentina Garibotto; Thomas Zilli Journal: Med Oncol Date: 2019-06-12 Impact factor: 3.064
Authors: Anna E Teeter; Joseph C Presti; William J Aronson; Martha K Terris; Christopher J Kane; Christopher L Amling; Stephen J Freedland Journal: Urology Date: 2010-12-08 Impact factor: 2.649
Authors: Michael E Ray; Kyounghwa Bae; Maha H A Hussain; Gerald E Hanks; William U Shipley; Howard M Sandler Journal: J Natl Cancer Inst Date: 2009-02-10 Impact factor: 13.506
Authors: Scott E Eggener; Andrew J Vickers; Angel M Serio; Michael J Donovan; Faisal M Khan; Valentina Bayer-Zubek; David Verbel; Carlos Cordon-Cardo; Victor E Reuter; Fernando J Bianco; Peter T Scardino Journal: Cancer Date: 2009-01-15 Impact factor: 6.860