Prostate-specific antigen velocity in untreated, localized prostate cancer.
MetadataShow full item record
OBJECTIVE: To report the results of a prospective study of active surveillance of untreated prostate cancer, with a focus on baseline predictors of prostate-specific antigen (PSA) velocity, as PSA velocity before treatment is an important predictor of prostate cancer mortality, and patients on active surveillance are monitored for several years to estimate the PSA velocity and thus select patients for radical treatment. PATIENTS AND METHODS: A prospective study of active surveillance for localized prostate cancer opened at the Royal Marsden Hospital in 2002. Eligible patients had clinical stage T1/T2a, N0/Nx, M0/Mx adenocarcinoma of the prostate with a serum PSA level of < 15 ng/mL, a Gleason score of < or = 7 with primary grade < or = 3, and less than half the biopsy cores positive. The PSA velocity before treatment was analysed in relation to baseline clinical characteristics. RESULTS: In all, 237 patients on surveillance were followed for a median of 24 months (median age 67 years; median initial PSA level 6.5 ng/mL; median pretreatment PSA velocity 0.44 ng/mL per year). On multivariate analysis, PSA density (i.e. serum PSA level/prostate volume) was the only significant determinant of PSA velocity (P < 0.001). Patients with a PSA density above or below the median (0.185 ng/mL/mL) had a median (interquartile range) PSA velocity of 0.92 (0.34-1.77) ng/mL per year and 0.35 (-0.06, 0.80) ng/mL per year, respectively. CONCLUSIONS: PSA density, which is readily available at the time of diagnosis, is an independent determinant of PSA velocity in untreated, localized prostate cancer. If this is confirmed, PSA density could be used to inform the often difficult choice between active surveillance and immediate radical treatment.
Version of record
Clinical Academic Radiotherapy (Dearnaley)
Clinical Academic Radiotherapy (Huddart)
License start date
BJU international, 2008, 101 (2), pp. 161 - 164
Showing items related by title, author, creator and subject.
Ki-67 and outcome in clinically localised prostate cancer: analysis of conservatively treated prostate cancer patients from the Trans-Atlantic Prostate Group study Berney, DM; Gopalan, A; Kudahetti, S; Fisher, G; Ambroisine, L; Foster, CS; Reuter, V; Eastham, J; Moller, H; Kattan, MW; Gerald, W; Cooper, C; Scardino, P; Cuzick, J; Grp, T-AP (NATURE PUBLISHING GROUP, 2009-03-17)Treatment decisions after diagnosis of clinically localised prostate cancer are difficult due to variability in tumour behaviour. We therefore examined one of the most promising biomarkers in prostate cancer, Ki-67, in a ...
Reply from Authors re: Tillmann Loch, Pat Fox Fulgham. Active Surveillance Challenges in Men with Prostate Cancer: Role of Imaging Today and Tomorrow. Eur Urol 2016;69:1034-6: Imaging in Active Surveillance for Prostate Cancer: Where Should We Focus Our Research? Henderson, DR; de Souza, NM; Parker, CC; van As, NJ (2016-06)
Management of patients with advanced prostate cancer: recommendations of the St Gallen Advanced Prostate Cancer Consensus Conference (APCCC) 2015. Gillessen, S; Omlin, A; Attard, G; de Bono, JS; Efstathiou, E; Fizazi, K; Halabi, S; Nelson, PS; Sartor, O; Smith, MR; Soule, HR; Akaza, H; Beer, TM; Beltran, H; Chinnaiyan, AM; Daugaard, G; Davis, ID; De Santis, M; Drake, CG; Eeles, RA; Fanti, S; Gleave, ME; Heidenreich, A; Hussain, M; James, ND; Lecouvet, FE; Logothetis, CJ; Mastris, K; Nilsson, S; Oh, WK; Olmos, D; Padhani, AR; Parker, C; Rubin, MA; Schalken, JA; Scher, HI; Sella, A; Shore, ND; Small, EJ; Sternberg, CN; Suzuki, H; Sweeney, CJ; Tannock, IF; Tombal, B (2016-05-02)