1924 PSA KINETICS DOES NOT PREDICT PROSTATE CANCER IN MEN SUBJECTED TO PROSTATE BIOPSY

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening (III)1 Apr 20131924 PSA KINETICS DOES NOT PREDICT PROSTATE CANCER IN MEN SUBJECTED TO PROSTATE BIOPSY Ignacio Iztueta Saavedra, Cristian Konstantinidis, Anna Celma, Fernando Ágreda, Jose Placer, Jacques Planas, and Juan Morote Ignacio Iztueta SaavedraIgnacio Iztueta Saavedra Barcelona, Spain More articles by this author , Cristian KonstantinidisCristian Konstantinidis Barcelona, Spain More articles by this author , Anna CelmaAnna Celma Barcelona, Spain More articles by this author , Fernando ÁgredaFernando Ágreda Barcelona, Spain More articles by this author , Jose PlacerJose Placer Barcelona, Spain More articles by this author , Jacques PlanasJacques Planas Barcelona, Spain More articles by this author , and Juan MoroteJuan Morote Barcelona, Spain More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2343AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES PSA velocity (PSAV) and PSA doubling time (PSADT) are the most significant parameters reflecting PSA kinetics. Their clinical usefulness in men at high risk of prostate cancer (PC) due to elevated serum PSA and/or suspicious digital rectal examination (DRE) remain controversial. The objective of this study was to analyse PSAV and PSADT as predictors of PC in men subjected to prostate biopsy (PB) focusing our attention in primary and repeated biopsies. METHODS A consecutive group of 528 men referred to PB with at least three available serum PSA determinations was selected. PSAV and PSADT were calculated using the MSKCC device. The median time between first and last PSA determinations was 15 months (5-64). The median age was 67 years (43-84). In 77.1% of men it was the first PB while in 15.1%, 7.4% and 0.4% it was the second, third and fourth PB respectively. The standard number of cores was 10 plus 1 to 8 additional ones according to age and prostate volume, according to a modified Vienna's nomogram. The overall detection rate of PC was 38.1% (44% in first PBs and 19% in repeat ones). Univariate and multivariate analysis were done including also percent free PSA (PFPSA) and PSA density (PSAD) as PC predictive variables. RESULTS Overall median PSAV was 1.2 ng/ml/year in men with negative PB and 1.4 ng/ml/year in men with PC, p=0.147. Overall median PSADT was 26.1 months and 26.3 months respectively, p=0.619. Similar results were founded in men subjected to the first PB and the repeat ones. Contrarily PSAD was significantly higher in men with PC, even at time of first PB or repeat ones. PFPSA was significantly lower in men with PC detected only at the time of first PB. Multivariate analysis showed that PSAD (OR 43.14, 95%CI 5.91–315.01, p<0.001) and PFPSA (OR 0.96, 95%CI 0.93-0.99, p<0.047) were the only predictive variables of PC at the time of first PB while only PSAD (OR 9.23, 95%CI 1.08-98.39, p<0.048) was in men scheduled to repeat PB. CONCLUSIONS PSA kinetics (PSAV and PSADT) were not useful to increase the specificity of serum PSA in men at high risk of PC due to elevated serum PSA and/or abnormal DRE. In contrast PSAD and PFPSA were of helpful to avoid unnecessary PBs in men scheduled to their first PB while only PSAD in men with repeat PB indication. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e789 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ignacio Iztueta Saavedra Barcelona, Spain More articles by this author Cristian Konstantinidis Barcelona, Spain More articles by this author Anna Celma Barcelona, Spain More articles by this author Fernando Ágreda Barcelona, Spain More articles by this author Jose Placer Barcelona, Spain More articles by this author Jacques Planas Barcelona, Spain More articles by this author Juan Morote Barcelona, Spain More articles by this author Expand All Advertisement Advertisement Loading ...