Prostate-Specific Antigen in Prostate Cancer

Kuriyama, Manabu

doi:10.1177/172460088600100202

Cited by 30 publications

(29 citation statements)

References 10 publications

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“…Around the time of the development of this new surgical technique, prostate-specific antigen (PSA) was discovered 43 and reported to be a potentially useful serum marker for prostate cancer [43][44][45] . The FDA soon approved measurement of PSA levels to monitor prostate cancer progression and response to therapy, and later approved the test for prostate cancer screening.…”

Section: Prostatectomymentioning

confidence: 99%

A history of prostate cancer treatment

2002

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The increased incidence of prostate cancer has led to remarkable changes in diagnosis and treatment over the past century. What were the first ways in which prostate cancer was treated, and how did these evolve into the variety of therapeutic strategies from which patients have to choose today?In 1853, J. Adams, a surgeon at The London Hospital, described the first case of prostate cancer, which he discovered by histological examination 1 . Adams noted in his report that this condition was "a very rare disease". Remarkably, 150 years later, prostate cancer has become a significant health problem. In the United States, it is the most commonly diagnosed cancer in men, with 180,000 new cases and about 31,000 deaths occurring annually 2 . This dramatic increase in the number of prostate cancer cases can be attributed to several causes. First, prostate cancer was not differentiated from other types of urinary obstruction until the early 1900s. Second, the incidence of prostate cancer increases more rapidly with age than any other cancer type 2 . The number of cases has risen as the average life expectancy has increased over the past century. Third, the increased incidence seems to be, in some way, related to the 'Western' lifestyle: the incidence of clinical prostate cancer is significantly lower in Asian populations, compared with Western populations 3 , and it

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Section: Prostatectomymentioning

confidence: 99%

A history of prostate cancer treatment

2002

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“…[7][8][9] However, it may precede clinical disease by many years. In fact, most patients will not develop any clinical manifestations despite having BCR.…”

Section: Discussionmentioning

confidence: 99%

“…Unlike other studies testing BCR and its predictors, [6][7][8][9][17][18][19][20] we wanted to formulate a personalized strategy for the initiation of salvage therapy for patients with a first detectable PSA. The first problem we encountered trying to move forward was that no data existed to estimate median time to BCR among PSA failures.…”

Section: Discussionmentioning

confidence: 99%

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Time from first detectable PSA following radical prostatectomy to biochemical recurrence: A competing risk analysis

Boo

Pintilie

Yip

et al. 2015

CUAJ

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Introduction: In this study, we estimated the time from first detectable prostate-specific antigen (PSA) following radical prostatecfollowing radical prostatectomy (RP) to commonly used definitions of biochemical recurrence (BCR). We also identified the predictors of time to BCR. Methods: We identified subjects who underwent a RP and had an undetectable PSA after surgery followed by at least 1 detectable PSA between 2000 and 2011. The primary outcome was time to BCR (PSA ≥0.2 and successive PSA ≥0.2) and prediction of the rate of PSA rise. Outcomes were calculated using a competing risk analysis, with univariable and multivariable Fine and Grey models. We employed a mixed effect model to test clinical predictors that are associated with the rate of PSA rise. Results: The cohort included 376 patients. The median follow-up from surgery was 60.5 months (interquartile range [IQR] 40.8-91.5) and from detectable PSA was 18 months (IQR 11-32). Only 45.74% (n = 172) had PSA values ≥0.2 ng/mL, while 15.16% (n = 57) reached the PSA level of ≥0.4 ng/mL and rising. On multivariable analysis, the values of the first detectable PSA and pathologic Gleason grade 8 or higher were consistently independent predictors of time to BCR. In the mixed effect model rate, the PSA rise was associated with time from surgery to first detectable PSA, Gleason score, and prostate volume. The main limitation of this study is the large proportion of patients that received treatment without reaching BCR. It is plausible that shorter estimated median times would occur at a centre that does not use salvage therapy at such an early state. Conclusion:The time from first detectable PSA to BCR may be lengthy. Our analyses of the predictors of the rate of PSA rise can help determine a personalized approach for patients with a detectable PSA after surgery. IntroductionRadical prostatectomy (RP) is the surgical treatment of choice for clinically localized prostate cancer. Prostatespecific antigen (PSA) monitoring is the primary tool for detecting relapse of cancer after RP. About 27% to 53% of men undergoing RP will have a detectable serum PSA within 10 years of surgery.1-5 Although biochemical recurrence (BCR) is an ominous finding and is associated with an increased risk of progression to metastatic disease, 6 it precedes clinical recurrence by many years.7-9 Furthermore, many patients with BCR will never progress.Currently, level 1 evidence suggests that adjuvant radiation should be administered to patients with high-risk prostate cancer following RP.10-13 However, adjuvant radiation has not been compared to early salvage radiation. [14][15][16] Therefore, most urologists would rather use early salvage therapy, most commonly offered after reaching BCR rather than after the first detectable PSA. 17 To the best of our knowledge, the time frame from the first detectable PSA to BCR has not been explored.In this study we used the 4 most accepted definitions for BCR: (1) PSA ≥0.2 ng/mL; (2) an initial PSA of ≥0.2 ng/mL and successive PSA ≥0.2 ng/mL; ...

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“…Later, in 1979, the purification of PSA from prostate tissue was succeeded (4), and in 1980 the PSA measurement technique in blood plasma was completed by ELISA method (5). For patients diagnosed with prostate cancer, the levels of serum prostate-specific antigen have been shown to be increased compared with healthy men (6). In the late 80's PSA was introduced as a screening test for prostate cancer (PC) and as an investigation it was meant to assess the efficacy of surgical or hormonal treatment for this condition (7)(8)(9).…”

Section: Background and Historymentioning

confidence: 99%