Do Prostate Cancer Patients With Markedly Elevated PSA Benefit From Radiation Therapy?

Abstract

Survival was significantly improved by radiotherapy for localized prostate cancer. Extremely high PSA levels (≥25 ng/mL) should not be considered a contraindication to local treatment.

Ultra-High Prostate-Specific Antigen Level: A Potential Very-High-Risk Factor for Localized High-Risk Prostate Cancer

“…Notably, the group with iPSA 20-50 ng/mL was not significantly different from the iPSA less than 20 ng/mL group, which may partly be a reason why the iPSA level could not incorporated as a VHR factor, because previous outcome analyses for VHR were conducted on results from surgical procedures which may exclude an uhPSA of ≥100 ng/mL. Accordingly, some authors have proposed that the uhPSA group is not a good candidate for local therapy and instead is a candidate for systemic therapy, partly because elevated PSA levels imply the existence of disease outside the prostate [16][17][18]. Our data partially concur with this opinion, because the uhPSA group showed increased PSA failure with more distant metastases, but not elevated local failure nor pelvic lymph node recurrence.…”