Serum prostate-specific antigen and prostate volume predict long-term changes in symptoms and flow rate: results of a four-year, randomized trial comparing finasteride versus placebo

Roehrborn, Claus G.; Boyle, Peter; Bergner, Donald; Gray, Todd; Gittelman, Marc; Shown, Thomas E.; Melman, Arnold; Bracken, R. Bruce; White, Ralph W. deVere; Taylor, Allison J.; Wang, Daniel; Waldstreicher, Joanne

doi:10.1016/s0090-4295(99)00232-0

Cited by 192 publications

(104 citation statements)

References 14 publications

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“…Our cutoff value for PSA of 1.5 ng/ml is also in line with the Proscar Long-term Efficacy and Safety Study (PLESS) by Roehrborn et al that showed that a PSA of 1.4 ng/ml (a quarter of all their participants) predicts the long-term response of finasteride treatment in men with clinical BPH [23].…”

Section: Discussionsupporting

confidence: 84%

Serum Prostate-Specific Antigen as a Predictor of Prostate Volume in the Community: The Krimpen Study

2007

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e u r o p e a n u r o l o g y 5 1 ( 2 0 0 7 ) 1 6 4 5 -1 6 5 3 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: Serum prostate-specific antigen (PSA) is considered a proxy for prostate volume (PV). This study investigates which range of PSA values has the best utility in the determination of PV (<30 cc, at 30, 40, and 50 cc), and whether PSA performs better than digital rectal examination (DRE) when estimating PV. Methods: In a population-based follow-up study of 1688 men in Krimpen aan den IJssel, The Netherlands, at baseline we estimated PV by DRE and by transrectal planimetric ultrasound (TRUS), in addition to measuring PSA. Men who tested positive for prostate cancer (PCa) at baseline and at 2 and 4 yr of follow-up were excluded from the analyses (n = 142). Of the men without PCa, PSA and PV data were available in 1524 participants. Results: Of all 1524 men analysed, 76.7% had a PSA of 0-2.0, 15.0% had a PSA of 2.1-4.0, and 8.3% a PSA > 4. Low PSA ranges (0-2 and 2.1-4.0) discriminate better for a PV of 30 cc (eg, in men with a PSA range of 2.1-2.5 ng/ml there was a 72% chance of having a PV > 30 cc). Higher ranges of PSA (>4.0) discriminate better for a PV > 40 or 50 cc. (eg, in men with a PSA in the range of 4.1-7.0 ng/ml there was a 69% chance of having a PV > 40 cc and in men with a PSA > 10 ng/ml there was a 75% chance of a PV > 50 cc). The receiver operating curve (ROC) for the performance of PSA in estimating a PV > 30 cc shows an area under the curve (AUC) of 0.79, denoting reasonable discrimination, and AUCs of 0.86 and 0.92, denoting good discrimination of PVs > 40 cc and >50 cc, respectively. PSA performed significantly better than DRE at estimating PV. Multiple regression analysis shows that both DRE and an interaction term for age and PSA provided minimal additional information beyond PSA in the prediction of PV; however, their contribution is numerically minimal/not clinically meaningful. Conclusions: In men for whom a diagnosis of PCa has been ruled out, PSA can be used to detect an enlarged prostate (>30 cc and with more accuracy PV > 40 or 50 cc). More precision in estimating PV can be obtained when using a formula that contains PSA, age, DRE, and an interaction term between age and PSA; however, the clinical advantage of the formula over PSA alone is only modest as shown by the ROC curves. Thus, for clinicians looking for an easy and fast way to identify patients with an enlarged prostate, PSA is a good approximation for men without PCa.

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Section: Discussionsupporting

confidence: 84%

Serum Prostate-Specific Antigen as a Predictor of Prostate Volume in the Community: The Krimpen Study

2007

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“…Therefore, patients with high-grade prostatic inflammation and IPSS had a significantly greater prostate volume (Mishra et al, 2007). As the prostate volume or PSA levels increase, so do the likelihood of symptom deterioration, the risk of acute urinary retention (AUR), and the possible need for BPHrelated surgery (Roehrborn et al, 1999;Madersbacher et al, 2007;Emberton et al, 2011).Compatible with these findings , according to our results, NLR was associated with IPSS, Qmax and clinical status of patients. In addition, PSA, and IPSS were positively correlated, and Qmax were negatively correlated with NLR; NLR (p<0.001, r=0.265) was more strongly positively correlated with these parameters than with ESR (p=0.03, r=0.251) and CRP (p>0.05, r=0.068).…”

Section: Discussionsupporting

confidence: 72%

Is the Neutrophil-Lymphocyte Ratio an Indicator of Progression in Patients with Benign Prostatic Hyperplasia?

Tanık

Albayrak²,

Zengın³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Purpose: The aim of this study was to evaluate inflammation parameters and assess the utility of the neutrophillymphocyte ratio (NLR) as a simple and readily available predictor for clinical disease activity in patients with nenign prostate hyperplasia BPH. We also aimed to investigate the relationship between inflammatory parameters with α-blocker therapy response, and evaluate the potential association between NLR and the progression of benign prostatic hyperplasia (BPH). Materials and Methods: We examined 320 consecutive patients ( .001); however, there were no significant differences between the groups in terms of age (p>0.05), and prostate volume (p>0.05). Conclusions: NLR can predict BPH progression. We propose that increased inflammation is negatively associated with clinical status in BPH patients and suggest that NLR can give information along with LUTS severity which may be used as a readikly accessible marker for patient follow-up.

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“…i5ARs may be prescribed to men with lower urinary tract symptoms and enlarged prostate (> 40 mL) or high prostate-specific antigen (PSA) levels (> 1.6 ng/mL) and may prevent disease progression, reducing both the need for surgery and acute urinary retention. 4,[7][8][9][10] (A) 11 (B) One limitation to the use of monotherapy with i5ARs is the onset of action: improvement of BPH-LUTS takes between 4 and 6 months of therapy. Finasteride and dutasteride have similar efficacy in reducing prostate volume and improving urinary symptoms in BPH.…”

Section: -Alpha-reductase Inhibitors (I5ars)mentioning

confidence: 99%

Treatment of benign prostatic hyperplasia

Nunes

Manzano

Truzzi

et al. 2017

Rev. Assoc. Med. Bras.

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Serum prostate-specific antigen and prostate volume predict long-term changes in symptoms and flow rate: results of a four-year, randomized trial comparing finasteride versus placebo

Cited by 192 publications

References 14 publications

Serum Prostate-Specific Antigen as a Predictor of Prostate Volume in the Community: The Krimpen Study

Serum Prostate-Specific Antigen as a Predictor of Prostate Volume in the Community: The Krimpen Study

Is the Neutrophil-Lymphocyte Ratio an Indicator of Progression in Patients with Benign Prostatic Hyperplasia?

Treatment of benign prostatic hyperplasia

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