OBJECTIVES: A PSA velocity (PSAV)>0.35 ng/ml/year approximately 10-15 years prior to diagnosis is associated with a greater risk of lethal prostate cancer. Some have recommended that a PSAV>0.35 ng/ml/year should prompt a prostate biopsy in men with a low serum PSA (<4 ng/ml) and benign DRE. However, less is known about the utility of this PSAV cutpoint for the prediction of treatment outcomes among men undergoing radical prostatectomy (RP). METHODS: Between 1992 and 2007, 339 men underwent RP at our institution with a preoperative PSA<4 ng/ml, benign DRE, and multiple preoperative PSA measurements. PSAV was calculated by linear regression analysis using all PSA values within 18 months prior to diagnosis. Kaplan-Meier survival analysis was performed, and biochemical progression rates were compared between PSAV strata using the log-rank test. RESULTS: The preoperative PSAV was >0.35 ng/ml/year in 124 (36.6%) of 339 men. Although there were no significant differences in clinico-pathological characteristics based upon PSAV, men with a PSAV>0.35 ng/ml/year were significantly more likely to experience biochemical progression after RP at a median follow-up of 4 years (P=0.022). CONCLUSIONS: In this low-risk population with a preoperative PSA<4 ng/ml and benign DRE, approximately 1/3 had a preoperative PSAV>0.35 ng/ml/year. Physicians should carefully monitor men with a preoperative PSA>0.35 ng/ml/year as they are at increased risk of biochemical progression following RP.
OBJECTIVES: A PSA velocity (PSAV)>0.35 ng/ml/year approximately 10-15 years prior to diagnosis is associated with a greater risk of lethal prostate cancer. Some have recommended that a PSAV>0.35 ng/ml/year should prompt a prostate biopsy in men with a low serum PSA (<4 ng/ml) and benign DRE. However, less is known about the utility of this PSAV cutpoint for the prediction of treatment outcomes among men undergoing radical prostatectomy (RP). METHODS: Between 1992 and 2007, 339 men underwent RP at our institution with a preoperative PSA<4 ng/ml, benign DRE, and multiple preoperative PSA measurements. PSAV was calculated by linear regression analysis using all PSA values within 18 months prior to diagnosis. Kaplan-Meier survival analysis was performed, and biochemical progression rates were compared between PSAV strata using the log-rank test. RESULTS: The preoperative PSAV was >0.35 ng/ml/year in 124 (36.6%) of 339 men. Although there were no significant differences in clinico-pathological characteristics based upon PSAV, men with a PSAV>0.35 ng/ml/year were significantly more likely to experience biochemical progression after RP at a median follow-up of 4 years (P=0.022). CONCLUSIONS: In this low-risk population with a preoperative PSA<4 ng/ml and benign DRE, approximately 1/3 had a preoperative PSAV>0.35 ng/ml/year. Physicians should carefully monitor men with a preoperative PSA>0.35 ng/ml/year as they are at increased risk of biochemical progression following RP.
Authors: Danil V Makarov; Elizabeth B Humphreys; Leslie A Mangold; Patrick C Walsh; Alan W Partin; Jonathan I Epstein; Stephen J Freedland Journal: J Urol Date: 2006-08 Impact factor: 7.450
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Authors: Jo Ann V Antenor; Kimberly A Roehl; Scott E Eggener; Shilajit D Kundu; Misop Han; William J Catalona Journal: Urology Date: 2005-07 Impact factor: 2.649
Authors: H Ballentine Carter; Luigi Ferrucci; Anna Kettermann; Patricia Landis; E James Wright; Jonathan I Epstein; Bruce J Trock; E Jeffrey Metter Journal: J Natl Cancer Inst Date: 2006-11-01 Impact factor: 13.506
Authors: H B Carter; J D Pearson; E J Metter; L J Brant; D W Chan; R Andres; J L Fozard; P C Walsh Journal: JAMA Date: 1992 Apr 22-29 Impact factor: 56.272
Authors: Ian M Thompson; Donna K Pauler; Phyllis J Goodman; Catherine M Tangen; M Scott Lucia; Howard L Parnes; Lori M Minasian; Leslie G Ford; Scott M Lippman; E David Crawford; John J Crowley; Charles A Coltman Journal: N Engl J Med Date: 2004-05-27 Impact factor: 91.245