PSA doubling time not a reliable predictor of progression after RP
MedWire News: A man’s prostate-specific antigen doubling time (PSADT) after radical prostatectomy (RP) for prostate cancer cannot reliably indicate whether he is likely to experience biochemical progression, say US researchers.
However, a short PSADT did indicate non-organ confined disease, reports the team.
“Postoperative PSADT predicts prostate cancer mortality in men with biochemical progression after treatment, but there is conflicting evidence on whether it also has a role in pretreatment prognostication,” explain William Catalona, from Northwestern University Medical Faculty Foundation in Chicago, Illinois, and team.
To investigate this conflict further, they calculated the PSADT for 1208 men in a large prostate cancer screening study who all underwent RP for the disease, and sought associations with tumor features and biochemical progression-free survival.
A total of 16% of the cohort had biochemical progression a median of 114 months after RP; however, their mean PSADT was similar to that for men who had no biochemical progression, at 51.4 months versus 50.4 months. Further univariate analysis failed to show any association between PSADT and biochemical progression.
In addition, 10-year biochemical progression-free survival was similar above and below the 18-month PSADT mark, and the 36-month or less mark.
Conversely, 74.9% of men had organ confined disease at RP, and the team found that mean PSADT was significantly higher in these men than in those with non-organ confined disease, at 52.1 months versus 45.7 months. et al in The Journal of Urology.
They conclude: “Caution should be exercised when using PSADT in the pretreatment setting.”
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By Sarah Guy