Authors: Danil V Makarov Stacy Loeb Ahmed Magheli Kevin Zhao Elizabeth Humphreys Mark L Gonzalgo Alan W Partin Misop Han
Publish Date: 2010/12/14
Volume: 29, Issue: 1, Pages: 11-14
Abstract
A PSA velocity PSAV 035 ng/ml/year approximately 10–15 years prior to diagnosis is associated with a greater risk of lethal prostate cancer Some have recommended that a PSAV 035 ng/ml/year should prompt a prostate biopsy in men with a low serum PSA 4 ng/ml and benign DRE However less is known about the utility of this PSAV cutpoint for the prediction of treatment outcomes among men undergoing radical prostatectomy RPBetween 1992 and 2007 339 men underwent RP at our institution with a preoperative PSA 4 ng/ml benign DRE and multiple preoperative PSA measurements PSAV was calculated by linear regression analysis using all PSA values within 18 months prior to diagnosis Kaplan–Meier survival analysis was performed and biochemical progression rates were compared between PSAV strata using the logrank testThe preoperative PSAV was 035 ng/ml/year in 124 366 of 339 men Although there were no significant differences in clinicopathological characteristics based upon PSAV men with a PSAV 035 ng/ml/year were significantly more likely to experience biochemical progression after RP at a median followup of 4 years P = 0022In this lowrisk population with a preoperative PSA 4 ng/ml and benign DRE approximately 1/3 had a preoperative PSAV 035 ng/ml/year Physicians should carefully monitor men with a preoperative PSA 035 ng/ml/year as they are at increased risk of biochemical progression following RP
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