Prognosis of patients with prostate cancer and middle range prostate - specific antigen levels of 20 – 100 ng / mL

Abstract

Introduction: Prostate - specific antigen (PSA) is a useful biomarker for detection of prostate cancer (PCa) and for risk classification in addition to TNM classification and Gleason score (GS). We reported the role of PSA in patients with low (< 20 ng / mL) and extremely high (≥ 100 ng / mL) PSA levels. However, it is unclear whether a correlation exists between middle range PSA levels (20 – 100 ng / mL) at diagnosis and prognosis. Materials and Methods: Between January 2000 and December 2014, 1873 patients underwent prostate biopsy at Kanazawa University Hospital. Of 802 patients who were diagnosed with PCa, 148 patients with middle range PSA levels (20 – 100 ng / mL) were retrospectively analyzed. Results: The percentage of patients with T3 – 4 consistently increased as PSA levels increased from 20 to 100 ng / mL. Although the percentage of patients with GS ≥ 8 or metastases increased as PSA levels increased up to approximately 70 ng / mL, there was no significant increase between 70 and 100 ng / mL. PCa - specific and castration - resistant PCa - free survivals were adversely associated with PSA levels up to 70 ng / mL, but not between 70 and 100 ng / mL. Conclusion: PSA is a useful biomarker for predicting prognosis at levels between 20 and 70 ng / mL. However, PSA cannot be used as a prognostic factor in patients with PCa and PSA levels ≥ 70 ng / mL. When the PSA level reaches approximately 70 ng / mL, prognosis might bottom and reach a plateau.

The Prognostic Value of Prostate Specific Antigen and Time to Psa Nadir in Castration-Resistant Prostate Cancer

“…The majority of patients with high initial PSA level reflects the severity of tumor characteristics or an asymptomatic tumor for a long period of time, indicating the possibility that the patient is neglectful of his condition [10]. A high PSA level also indicates a high androgen receptor activity of prostate cancer cells [11]. Previous studies also highlighted the mortality risk of a high PSA level [12].…”

“…The differences of the findings in this study compared to previous studies may be due to the small number of samples in this study. Several studies suggested that a low TTC is due to PSA volume and PSA doubling time difference [11].…”

Metastatic Profile of Newly Diagnosed Prostate Cancer Patients in Calabar, South- South Nigeria

“…Even though this is the norm, certain patients have been noted to develop metastatic CaP at low PSAs. PSAs as low as 0.02ng/ml have been recorded in such patients and they are noted to have undifferentiated and very aggressive disease [24,25,26] Iwamoto and colleagues [27] in their study from 2000-2014 on 1873 patients had concluded that PSA is a useful biomarker for predicting prognosis at levels between 20 and 70 ng/ml. While Gleason's score is the single most important predictor of prostate cancer prognosis, the new grading system, known as the Grade Grouping System, better classifies CaP [28].…”

The multiparametric prostate resonance imaging with the prostate imaging-reporting and data system (PI-RADS): the state of art of prostate cancer diagnosis

“…Prostate cancer had important modifications in diagnosis, clinical management and surgical treatment in last years (8)(9)(10)(11). Multiparametric magnetic resonance imaging (mpMRI) has become the standard of care and provides useful information for prostate cancer diagnosis (12).…”