Use of pretreatment prostate-specific antigen doubling time to predict outcome after radical prostatectomy

Abstract

The objective of this study was to better understand the implications of the rate of prostate-speci®c antigen (PSA) changes in prostate carcinoma. We retrospectively calculated PSA doubling times prior to surgery in 62 patients with prostate carcinoma. The calculated values were compared with ®nal pathologic ®ndings and with rates of PSA failure after surgery. PSA values increased during the period of observation in 82.3% of the patients, whereas 17.7% had levels that remained stable. The median calculated PSA doubling time in those with increasing levels was 25.8 months, with doubling times 24 months observed in 37.1% of the patients. Stage pT3 disease was more common in patients with PSA doubling times of 36 months than in those with doubling times b 36 months (P 0.02). Biochemical failure was more common in patients with rapid PSA doubling times (P`0.01). The calculated PSA doubling time prior to radical surgery is signi®cantly associated with the ®nal pathologic ®ndings. Early PSA failure is more common in patients with rapid PSA doubling times prior to radical surgery. Prostate Cancer and Prostatic Diseases (2000) 3, 269±274.

Other Paradigms: Growth Rate Constants and Tumor Burden Determined Using Computed Tomography Data Correlate Strongly With the Overall Survival of Patients With Renal Cell Carcinoma

“…The finding that tumor growth rate is of critical importance in determining outcome is consistent with other studies that have examined tumor doubling times, albeit in the absence of therapy 34–37. It is important to note that there is a fixed ratio between any determined growth rate constant and the doubling time, a fact well known to enzyme kineticists.…”

Clinical significance of the prostate-specific antigen doubling time prior to and following radical prostatectomy to predict the outcome of prostate cancer

“…The results in the present study are similar to those mentioned by Egawa et al (20). In addition, in the present paper, it has been demonstrated that pre-PSADT is an independent factor for PSA failure, similar to the results obtained for the biopsy Gleason score and clinical stage via the multivariate logistic regression analysis (Table IV).…”

“…However, in their study, the median followup period following radical surgery was only 17.3 months, which they reported was an improvement compared with conducting a longer follow-up to examine the correlation of pre-PSADT with the pathological stage and PSA failure. Egawa et al (20) retrospectively studied pre-PSADT in 62 patients with T1-3N0M0 prostate cancer, and reported that pre-PSADT is significantly associated with the final pathological stage and PSA failure following radical prostatectomy. Pathological stage, n (%) Specimen Gleason score, n (%) Early PSA failure was revealed to be more common in patients with rapid PSADT.…”

Oncological and functional outcomes 1 year after radical prostatectomy for very‐low‐risk prostate cancer: results from the prospective LAPPRO trial

“…Another limitation is the absence of PSA history for this cohort of very low risk prostate cancer that underwent surgery. It is common to advise against active surveillance in men with a PSA doubling time (PSADT) < 3 years 2930 or if there is a rise in PSA of more than 2 ng/ml/y before starting active surveillance 3132 . It cannot be entirely ruled out that the lack of data on PSA history, as well as the absence of a repeat biopsy, may influence the extent of adverse pathology after surgery in this study.…”