MP35-12 PSA PREDICTS DEVELOPMENT OF INCIDENT LOWER URINARY TRACT SYMPTOMS: RESULTS FROM THE REDUCE STUDY

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Epidemiology & Evaluation1 Apr 2016MP35-12 PSA PREDICTS DEVELOPMENT OF INCIDENT LOWER URINARY TRACT SYMPTOMS: RESULTS FROM THE REDUCE STUDY Tom Feng, Ross Simon, Lauren Howard, Adriana Vidal, Daniel Moreira, Ramiro Castro-Santamaria, Gerald Andriole, Claus Roehrborn, and Stephen Freedland Tom FengTom Feng More articles by this author , Ross SimonRoss Simon More articles by this author , Lauren HowardLauren Howard More articles by this author , Adriana VidalAdriana Vidal More articles by this author , Daniel MoreiraDaniel Moreira More articles by this author , Ramiro Castro-SantamariaRamiro Castro-Santamaria More articles by this author , Gerald AndrioleGerald Andriole More articles by this author , Claus RoehrbornClaus Roehrborn More articles by this author , and Stephen FreedlandStephen Freedland More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1604AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Benign prostatic hyperplasia (BPH) is known to increase serum PSA levels. However, the relationship of PSA to the development of lower urinary tract symptom (LUTS) in asymptomatic men is unknown. We evaluated the association between baseline PSA and incident LUTS in a large cohort of men with mild to no LUTS from REDUCE. METHODS REDUCE was a 4-year, multicenter, randomized, double-blind, placebo-controlled study that followed biopsy-negative men testing dutasteride for prostate cancer risk reduction. Eligible men were aged 50-75 years, had serum PSA between 2.5-10 ng/mL, a prior negative prostate biopsy, and baseline prostate volume<80 cc. During the 4 year study, men completed the International Prostate Symptom Score (IPSS) every 6 months. Exclusion criteria included men on BPH medical therapy or baseline IPSS≥8. Incident LUTS was defined as the first report of medical treatment, surgery, or sustained clinically significant BPH symptoms defined as two reports of IPSS>14. Men who progressed within 30 days of study enrollment were excluded. Cox proportional hazards were used to test whether PSA as a continuous and categorical variable independently predicted time to incident LUTS adjusting for key clinical variables (e.g. age, prostate size, and IPSS). RESULTS Of the 3,060 men who met study enrollment criteria, 329 (10.7%) progressed to symptomatic BPH. There were 643 men with PSA ≤4ng/mL, 1,200 men with PSA 4-6ng/mL, and 1,217 men with PSA >6ng/mL. As a continuous variable, higher PSA was significantly associated with increased incident LUTS in crude (HR 1.07, p=0.012) and adjusted models (HR 1.07, p=0.031). Likewise, baseline PSA >6.0 ng/mL was associated with increased incident LUTS vs. the reference group (PSA≤4ng/mL) in crude (HR 1.56, p=0.006) and adjusted models (HR 1.49, p=0.016). Increased risk of LUTS was also observed in men with PSA between 4-6 ng/mL, though the association was not statistically significant (HR 1.37, p=0.084). Cumulative incidence curves for risk of LUTS among the three PSA groups are shown in Figure 1. CONCLUSIONS Men with mild to no LUTS but increased PSA, >6ng/mL in particular, are at increased risk of developing incident LUTS presumed due to BPH. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e484 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Tom Feng More articles by this author Ross Simon More articles by this author Lauren Howard More articles by this author Adriana Vidal More articles by this author Daniel Moreira More articles by this author Ramiro Castro-Santamaria More articles by this author Gerald Andriole More articles by this author Claus Roehrborn More articles by this author Stephen Freedland More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...