Half-Life of Prostate-Specific Antigen after Radical Prostatectomy: The Decisive Predictor of Curative Treatment?

Semjonow, Axel; Hamm, Michael W.; Rathert, Peter

doi:10.1159/000474838

Cited by 28 publications

(18 citation statements)

References 19 publications

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“…This finding is in line with that of Zagars et al [2], who observed a statistically significant association with a shorter half-life in patients with a higher pre-treatment PSA, but noted that the degree of correlation was weak. The study by Ritter et al [5] did not observed a significant association between pre-treatment PSA level and PSA half-life, and neither our study nor those by Zagars [2] or Ritter [5] observed a significant association between PSA half-life and either Gleason score or pathological tumor stage. We should note that lack of statistical associations between baseline characteristics and PSA half-life does not exclude its possibility.…”

Section: Discussioncontrasting

confidence: 85%

“…Related to this, the degree of variability in PSA half-life appears to be greater after RT compared to definitive radiotherapy. Specifically, the maximum PSA half-life was 28.5 months in our study, which is far higher than the 9.2 months reported by Zagars et al [2] and the approximately 7 months reported by Ritter et al [5] Furthermore, the SD of PSA half-life was greater in our study (4.2 months) compared to that of Ritter et al 5 (1.3 months), and there was a generally greater degree of variability in PSA half-life evident in the frequency histogram displayed in our study (Figure 1) compared to that of the other two studies [2] [5]. It is unclear why there may be a longer half-life in the SRT setting, but it may be related to relative hypoxia in the tumor microenvironment (in a postoperative state), intrinsic tumor heterogeneity or prognostic factor differences between these study populations.…”

Section: Discussioncontrasting

confidence: 69%

“…In a study of 841 men who underwent definitive primary radiotherapy, Zagars et al found that median PSA half-life was 1.6 months [2]. A smaller study by Ritter et al of 63 patients who underwent definitive radiotherapy observed a median PSA half-life of 2.6 months [5]. Related to this, the degree of variability in PSA half-life appears to be greater after RT compared to definitive radiotherapy.…”

Section: Discussionmentioning

confidence: 97%

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Estimation of PSA Half-Life Following Salvage Radiation Therapy

Patel¹,

Tzou²,

Heckman³

et al. 2018

JCT

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Background: We aim to estimate prostate-specific antigen (PSA) half-life after salvage radiation therapy (SRT) in patients with detectable PSA after radical prostatectomy (RP). Methods: A total of 272 patients treated with salvage radiotherapy between July 1987 and July 2010 were included in this IRB approved retrospective analysis. The median pre-salvage radiotherapy dose was 0.6 ng/mL (range, 0.2 -21.9 ng/mL), 47 patients had at least a minimum tumor stage of T3b, 29 had a Gleason score over 7, and median dose was 66.6 Gy (range, 54.0 -72.4 Gy). Results: The estimated PSA half-life in our cohort of patients was 3.0 months (95% CI, 2.9 -3.2 months; range, 0.5 -28.5 months). There was no evidence of a statistically significant association between PSA half-life and any baseline clinicopathologic characteristics. The median interval between individual PSA measurements was noted to be 4.6 months (range, 0.1 -20.4 months). The median interval from the start of radiation therapy to the nadir PSA was 6.3 months (range, 1.3 -79.1 months). PSA half-life remained approximately 3.0 months when accounting for infrequent and outlier PSA values. Conclusion: The PSA half-life after definitive RT has been reported to be approximately 1.6 months. Our analysis found the PSA half-life after SRT to be approximately twice that of patients treated with definitive RT. These results provide useful information to radiation oncologists when counseling patients both before and after SRT regarding expectations about PSA How to cite this paper:

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Section: Discussioncontrasting

confidence: 85%

Section: Discussioncontrasting

confidence: 69%

Section: Discussionmentioning

confidence: 97%

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Estimation of PSA Half-Life Following Salvage Radiation Therapy

Patel¹,

Tzou²,

Heckman³

et al. 2018

JCT

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“…Indeed, using the Pros-check assay, PSA levels increase 1.4-to 1.9-fold in comparison with monoclonal assays (Hybritech, IMX) [7], According to the actual knowledge of PSA as a tissue marker, it seems that one of its best applications is the follow-up of patients after radical treatment. Due to its half-life [8], PSA decrease must be complete 16-30 days after surgery. PSA is the best single marker to monitor ml is used as an indicator of progression, but it is impor tant to repeat PSA determinations to detect an exponen tial elevation.…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of Pathological Features for Progression after Radical Prostatectomy

Ravery¹,

Boccon-Gibod²,

Meulemans³

et al. 1994

Eur Urol

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“…Following successful surgery, PSA should decrease to undetectable levels (198,199 ). Persistently increased PSA provides evidence of residual disease.…”

Section: Psa In Patient Managementmentioning

confidence: 99%

National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines for Use of Tumor Markers in Testicular, Prostate, Colorectal, Breast, and Ovarian Cancers

et al. 2008

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Background: Updated National Academy of Clinical Biochemistry (NACB) Laboratory Medicine Practice Guidelines for the use of tumor markers in the clinic have been developed. Methods: Published reports relevant to use of tumor markers for 5 cancer sites—testicular, prostate, colorectal, breast, and ovarian—were critically reviewed. Results: For testicular cancer, α-fetoprotein, human chorionic gonadotropin, and lactate dehydrogenase are recommended for diagnosis/case finding, staging, prognosis determination, recurrence detection, and therapy monitoring. α-Fetoprotein is also recommended for differential diagnosis of nonseminomatous and seminomatous germ cell tumors. Prostate-specific antigen (PSA) is not recommended for prostate cancer screening, but may be used for detecting disease recurrence and monitoring therapy. Free PSA measurement data are useful for distinguishing malignant from benign prostatic disease when total PSA is <10 μg/L. In colorectal cancer, carcinoembryonic antigen is recommended (with some caveats) for prognosis determination, postoperative surveillance, and therapy monitoring in advanced disease. Fecal occult blood testing may be used for screening asymptomatic adults 50 years or older. For breast cancer, estrogen and progesterone receptors are mandatory for predicting response to hormone therapy, human epidermal growth factor receptor-2 measurement is mandatory for predicting response to trastuzumab, and urokinase plasminogen activator/plasminogen activator inhibitor 1 may be used for determining prognosis in lymph node–negative patients. CA15-3/BR27–29 or carcinoembryonic antigen may be used for therapy monitoring in advanced disease. CA125 is recommended (with transvaginal ultrasound) for early detection of ovarian cancer in women at high risk for this disease. CA125 is also recommended for differential diagnosis of suspicious pelvic masses in postmenopausal women, as well as for detection of recurrence, monitoring of therapy, and determination of prognosis in women with ovarian cancer. Conclusions: Implementation of these recommendations should encourage optimal use of tumor markers.

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Half-Life of Prostate-Specific Antigen after Radical Prostatectomy: The Decisive Predictor of Curative Treatment?

Cited by 28 publications

References 19 publications

Estimation of PSA Half-Life Following Salvage Radiation Therapy

Estimation of PSA Half-Life Following Salvage Radiation Therapy

Predictive Value of Pathological Features for Progression after Radical Prostatectomy

National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines for Use of Tumor Markers in Testicular, Prostate, Colorectal, Breast, and Ovarian Cancers

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