1722 USE OF PSA DERIVATIVES TO DETERMINE THE NEED FOR REPEAT BIOPSY

Abstract

You have accessJournal of UrologyProstate Cancer: Detection and Screening I1 Apr 20101722 USE OF PSA DERIVATIVES TO DETERMINE THE NEED FOR REPEAT BIOPSY Donghui Kan, Stacy Loeb, Phillip R. Cooper, and William Catalona Donghui KanDonghui Kan Chicago, IL More articles by this author , Stacy LoebStacy Loeb Baltimore, MD More articles by this author , Phillip R. CooperPhillip R. Cooper Chicago, IL More articles by this author , and William CatalonaWilliam Catalona Chicago, IL More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1570AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES For men with a negative initial prostate biopsy, there is considerable variation in practice patterns regarding the decision for repeat biopsy. The 2010 NCCN Guidelines recommend the use of PSA derivatives to evaluate the need for repeat biopsy. We examined the joint use of %fPSA, PSA velocity (PSAV), and PSA density (PSAD) to predict repeat biopsy results following an initial negative biopsy. METHODS We identified 650 men from a large prostate cancer (CaP) screening study with a PSA of 2.5 to 10 ng/mL and negative digital rectal examination, who had an initial negative prostate biopsy and underwent at least one additional biopsy. In the 241 men with subsequent measurements of all PSA derivatives, we examined the use %fPSA, PSAV, and PSAD to predict the results of the next repeat biopsy and to predict an eventual diagnosis of CaP at any point during the study interval. RESULTS In the 241 men with an initial negative biopsy, 36 (14.9%) were diagnosed with CaP on the second biopsy, and an additional 11 (4.6%) were diagnosed with CaP on a subsequent repeat biopsy. Men with a %fPSA <10, PSAD >0.10, and PSAV >0.35 ng/mL/year were significantly more likely to be diagnosed with prostate cancer on the second biopsy (45.5% vs. 13.5%, p=0.013) or at any point during follow-up (54.6% vs. 17.8%, p=0.009), compared to men who did not. CONCLUSIONS PSA derivatives are useful for risk stratification following an initial negative prostate biopsy. Men with a %fPSA <10, PSAD >0.10, and PSAV >0.35 ng/mL/year are at significantly greater risk of subsequent prostate cancer detection. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e665 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Donghui Kan Chicago, IL More articles by this author Stacy Loeb Baltimore, MD More articles by this author Phillip R. Cooper Chicago, IL More articles by this author William Catalona Chicago, IL More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...