Prostate-specific antigen change in the european randomized study of screening for prostate cancer, section rotterdam

Raaijmakers, René; Wildhagen, Mark F.; Ito, Kazuto; Páez, Álvaro; Vries, Stijn H. de; Roobol, Monique J.; Schröder, Fritz H.

doi:10.1016/j.urology.2003.09.028

Cited by 80 publications

(29 citation statements)

References 16 publications

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“…PSA initial , PSA nadir and DT were defined in the same way as in PSAHL's equation. It was similar to the formula for PSAV [9,10], but the PSAV reflected an increasing tendency whereas the PSAVd represented a decreasing tendency. Two or more determinations between the PSA initial and the PSA nadir were required to capture a sufficiently long time interval [11].…”

Section: Definitions and Calculations Of Psahl Psavd Psadt And Psavsupporting

confidence: 65%

Prostate-specific antigen half-life: a new predictor of progression-free survival and overall survival in Chinese prostate cancer patients

et al. 2009

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We investigated the potential value of prostate-specific antigen half-life (PSAHL) and decreasing velocity (PSAVd) to predict progression-free survival (PFS) and overall survival (OS) in Chinese patients with prostate cancer. A total of 153 patients treated with hormonal therapy were included in the study. Of these, 78 patients progressed to hormonerefractory prostate cancer (HRPC) and 24 patients died by the end of follow-up. PSAHL was defined as the time during which prostate-specific antigen (PSA) concentration became half of the initial value during the first hormonal therapy. PSAVd reflected the decreasing velocity of PSA during the first hormonal therapy. PFS was defined as the interval from the beginning of hormonal therapy to HRPC. Cox proportional hazards regression analysis was used to evaluate whether PSAHL and PSAVd were significantly associated with PFS and OS. The median PSAHL and PSAVd were 0.50 months and 33.8 ng mL −1 per month. The median PFS and OS were 22.7 months (95% confidence interval [CI], 22.0-29.6 months) and 43.5 months (95% CI, 37.9-48.4 months), respectively. On univariate and multivariate analysis, long PSAHL (> 0.5 months), metastatic disease, high biopsy Gleason scores (≥ 8) and high nadir PSA (> 0.4 ng mL −1 ) were all found to be significantly associated with short PFS. Long PSAHL, high nadir PSA and short PSA doubling time (PSADT ≤ 2.0 months) were significantly associated with short OS. There were no significant relationships between PSAVd and either PFS or OS. Thus, PSAHL is a promising new independent predictor of survival. Patients with long PSAHL were identified as those at high risk for a relatively short PFS and OS.

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Section: Definitions and Calculations Of Psahl Psavd Psadt And Psavsupporting

confidence: 65%

Prostate-specific antigen half-life: a new predictor of progression-free survival and overall survival in Chinese prostate cancer patients

et al. 2009

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“…A true PSA of 4.5 ng/ml may therefore produce measured PSA results ranging from 3.0-6.0 ng/ml. By using only two values to calculate PSAV (FL) [9][10][11], it is assumed that each value lies close to the true PSA. Measured PSA values at the upper or lower limits of variability may produce a misleading PSAV, even when these are taken over a long time period, as occurred in the studies from the European Randomised Study of Screening for Prostate Cancer [9][10][11].…”

Section: Discussionmentioning

confidence: 99%

“…Although these findings have since been confirmed by others [4,5], the optimal cutoff remains controversial, particularly at low PSA levels [4,7,8]. Contrary to these studies, others have reported that PSAV has little additional benefit over a single PSA cutoff [9][10][11]. The conflicting evidence from these reports may relate to variation in the populations studied, although a possible contributing factor may be that the method of PSAV calculation was not standardised.…”

Section: Introductionmentioning

confidence: 89%

Methods of Calculating Prostate-Specific Antigen Velocity

et al. 2007

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e u r o p e a n u r o l o g y 5 2 ( 2 0 0 7 ) 1 0 4 4 -1 0 5 1 a v a i l a b l e a t w w w . s c i e n c e d i r e c t . c o m j o u r n a l h o m e p a g e : w w w . e u r o p e a n u r o l o g y . c o m Article info AbstractObjectives: Numerous methods of calculating PSA velocity (PSAV) are used and have the potential to produce differing PSAV results from the same PSA data. We calculated PSAV using three common methods and compared differences between the methods and their predictive value for prostate cancer diagnosis. Methods: From a population-based database of PSA results, men with initial PSA < 10.0 ng/ml and a subsequent diagnosis of prostate cancer or benign histology were identified. Those with !3 PSA tests before diagnosis carried out over a minimum of 18 mo were included. PSAV was calculated by using three methods:1. Arithmetic equation of change in PSA over time (AE) 2. Linear regression (LR) 3. Rate of PSA change using first and last values only (FL)The differences between the methods and test characteristics of each method were compared. Results: Of the 2204 men included, 716 (32.5%) were diagnosed with prostate cancer and 1488 (67.5%) benign histology. PSAV differed markedly in each method of calculation. The LR and FL methods had similar predictive values, which were higher than the AE method. There was strong agreement for cancer diagnosis between LR and FL (kappa = 0.85), with weaker agreement between LR/AE and FL/AE (kappa = 0.69 and 0.66, respectively). Conclusions: Methods used to calculate PSAV using the same PSA data can produce markedly different results. Linear regression should be the method of choice for calculating PSAV. Using first and last PSA values only may be adequate for everyday clinical use, as long as measurements are separated by a sufficiently long time period.

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“…This leads to potentially unnecessary biopsy procedures [18]. Another study revealed that the lack of specificity of PSA measurement as the only biopsy indicator is most easily pointed out by the observation that in only 20% to 30% of biopsied men with a PSA value greater than 4.0 ng/mL is prostate cancer detected thus, approximately 70% to 80% of these men have a false-positive test result [19].…”

Section: Discussionmentioning

confidence: 99%

Changes in Serum Prostate-Specific Antigen after Treatment with Antibiotics in Patients with Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia with Prostatitis

2010

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Purpose: Many urologists have performed prostate biopsy in men with a high level of prostate-specific antigen (PSA) alone. However, high levels of PSA may be induced by infection. We studied the effects of antibiotics on serum total PSA and PSA density (PSAD) in men with total PSA between 4 and 10 ng/ml and normal digital rectal examination (DRE) and transrectal sonographic findings. Materials and Methods: From January 2005 to October 2009, a total of 107 patients with complaints of lower urinary tract symptoms (LUTS) or benign prostatic hyperplasia (BPH) were evaluated. To be included in this study, patients had to be at least 50 years old, have a palpably normal DRE, have infection in the prostate, have a total serum PSA of 4 to 10 ng/ml, and have transrectal ultrasound findings that did not show a hypoechoic lesion in the prostate. Only patients in whom the PSA level was rechecked after short-term antibiotics administration (8 weeks) were included. Serum PSA and PSAD were measured before transrectal ultrasound or EPS and after 8 weeks of treatment with antibiotics (quinolone). Age, prostate volume, serum PSA, PSAD, and PSA rate of change were compared. Results: The mean age of the patients was 66.3 years. The mean prostate size was 48.8±24.9 g. Forty patients had a high level of PSAD. Total PSA and PSAD significantly decreased after treatment (p <0.05). In 45 of the 107 men, total PSA after antibiotics treatment was normalized (less than 4 ng/ml). PSAD after treatment was normalized (less than 0.15 ng/ml/cm 3 ) in 23 of the 40 patients with a high level of PSAD. Conclusion: Antibiotics treatment for at least 8 weeks in BPH patients with an increased PSA level (4-10 ng/ml), infection, and normal DRE and transrectal sonographic findings may decrease serum PSA significantly. However, because the PSA level was not decreased to the normal range (less than 4 ng/ml) in all patients, it seems that antibiotics therapy before prostatic biopsy is not necessary.

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Prostate-specific antigen change in the european randomized study of screening for prostate cancer, section rotterdam

Cited by 80 publications

References 16 publications

Prostate-specific antigen half-life: a new predictor of progression-free survival and overall survival in Chinese prostate cancer patients

Prostate-specific antigen half-life: a new predictor of progression-free survival and overall survival in Chinese prostate cancer patients

Methods of Calculating Prostate-Specific Antigen Velocity

Changes in Serum Prostate-Specific Antigen after Treatment with Antibiotics in Patients with Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia with Prostatitis

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