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Evaluation of prediagnostic prostate-specific antigen dynamics as predictors of death from prostate cancer in patients treated conservatively

O'Brien, M. Frank ; Cronin, Angel M. ; Fearn, Paul A. ; Savage, Caroline J. ; Smith, Brandon ; Stasi, Jason ; Scardino, Peter T. ; Fisher, Gabrielle ; Cuzick, Jack and Møller, Henrik , et al. (2011) In International Journal of Cancer 128(10). p.2373-2381
Abstract

Prostate-specific antigen (PSA) dynamics have been proposed to predict outcome in men with prostate cancer. We assessed the value of PSA velocity (PSAV) and PSA doubling time (PSADT) for predicting prostate cancer-specific mortality (PCSM) in men with clinically localized prostate cancer undergoing conservative management or early hormonal therapy. From 1990 to 1996, 2,333 patients were identified, of whom 594 had two or more PSA values before diagnosis. We examined 12 definitions for PSADT and 10 for PSAV. Because each definition required PSA measurements at particular intervals, the number of patients eligible for each definition varied from 40 to 594 and number of events from 10 to 119. Four PSAV definitions, but no PSADT, were... (More)

Prostate-specific antigen (PSA) dynamics have been proposed to predict outcome in men with prostate cancer. We assessed the value of PSA velocity (PSAV) and PSA doubling time (PSADT) for predicting prostate cancer-specific mortality (PCSM) in men with clinically localized prostate cancer undergoing conservative management or early hormonal therapy. From 1990 to 1996, 2,333 patients were identified, of whom 594 had two or more PSA values before diagnosis. We examined 12 definitions for PSADT and 10 for PSAV. Because each definition required PSA measurements at particular intervals, the number of patients eligible for each definition varied from 40 to 594 and number of events from 10 to 119. Four PSAV definitions, but no PSADT, were significantly associated with PCSM after adjustment for PSA in multivariable Cox proportional hazards regression. All four could be calculated only for a proportion of events, and the enhancements in predictive accuracy associated with PSAV had very wide confidence intervals. There was no clear benefit of PSAV in men with low PSA and Gleason grade 6 or less. Although evidence that certain PSAV definitions help to predict PCSM in the cohort exist, the value of incorporating PSAV in predictive models to assist in determining eligibility for conservative management is, at best, uncertain.

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publishing date
type
Contribution to journal
publication status
published
keywords
prediction, prostate-specific antigen, prostate-specific antigen doubling time, prostate-specific antigen velocity, watchful waiting
in
International Journal of Cancer
volume
128
issue
10
pages
9 pages
publisher
John Wiley & Sons Inc.
external identifiers
  • scopus:79953205605
  • pmid:20658531
ISSN
0020-7136
DOI
10.1002/ijc.25570
language
English
LU publication?
no
id
fe898a6a-2842-4b32-9256-a2f20692ad5f
date added to LUP
2022-12-06 15:29:55
date last changed
2024-01-03 21:35:17
@article{fe898a6a-2842-4b32-9256-a2f20692ad5f,
  abstract     = {{<p>Prostate-specific antigen (PSA) dynamics have been proposed to predict outcome in men with prostate cancer. We assessed the value of PSA velocity (PSAV) and PSA doubling time (PSADT) for predicting prostate cancer-specific mortality (PCSM) in men with clinically localized prostate cancer undergoing conservative management or early hormonal therapy. From 1990 to 1996, 2,333 patients were identified, of whom 594 had two or more PSA values before diagnosis. We examined 12 definitions for PSADT and 10 for PSAV. Because each definition required PSA measurements at particular intervals, the number of patients eligible for each definition varied from 40 to 594 and number of events from 10 to 119. Four PSAV definitions, but no PSADT, were significantly associated with PCSM after adjustment for PSA in multivariable Cox proportional hazards regression. All four could be calculated only for a proportion of events, and the enhancements in predictive accuracy associated with PSAV had very wide confidence intervals. There was no clear benefit of PSAV in men with low PSA and Gleason grade 6 or less. Although evidence that certain PSAV definitions help to predict PCSM in the cohort exist, the value of incorporating PSAV in predictive models to assist in determining eligibility for conservative management is, at best, uncertain.</p>}},
  author       = {{O'Brien, M. Frank and Cronin, Angel M. and Fearn, Paul A. and Savage, Caroline J. and Smith, Brandon and Stasi, Jason and Scardino, Peter T. and Fisher, Gabrielle and Cuzick, Jack and Møller, Henrik and Oliver, R. Timothy and Berney, Daniel M. and Foster, Christopher S. and Eastham, James A. and Vickers, Andrew J. and Lilja, Hans}},
  issn         = {{0020-7136}},
  keywords     = {{prediction; prostate-specific antigen; prostate-specific antigen doubling time; prostate-specific antigen velocity; watchful waiting}},
  language     = {{eng}},
  month        = {{05}},
  number       = {{10}},
  pages        = {{2373--2381}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{International Journal of Cancer}},
  title        = {{Evaluation of prediagnostic prostate-specific antigen dynamics as predictors of death from prostate cancer in patients treated conservatively}},
  url          = {{http://dx.doi.org/10.1002/ijc.25570}},
  doi          = {{10.1002/ijc.25570}},
  volume       = {{128}},
  year         = {{2011}},
}