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

Takeuchi,Hisashi; Ohori,Makoto; Tachibana,Masaaki

doi:10.3892/mco.2016.1116

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

Authors:
- Hisashi Takeuchi
- Makoto Ohori
- Masaaki Tachibana
View Affiliations

Affiliations: Department of Urology, Tokyo Medical University Ibaraki Medical Center, Ibaraki 300‑0395, Japan, Department of Urology, Tokyo Medical University, Tokyo 163-0023, Japan
Published online on: December 22, 2016 https://doi.org/10.3892/mco.2016.1116
Pages: 249-254

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

With the advent of serum prostate-specific antigen (PSA), a larger number of prostate cancers in the early phase have been successfully detected. Although decisions to perform prostate biopsies are routinely based on PSA levels, the PSA level is easily influenced by benign prostatic hyperplasia, with poor specificity. Therefore, the aim of the present study was to assess the clinical significance of prostate-specific antigen doubling time (PSADT) prior to and following radical prostatectomy. In total, 488 patients with T1c-3N0M0 prostate cancer who underwent radical prostatectomy were included. Preoperative and postoperative PSADT were retrospectively correlated with pathological and clinical outcomes. Preoperative PSADT was measured in 204 of the 488 patients. In total, 16 out of 20 patients with a preoperative PSADT of >24 months had a cancer confined to the prostate compared with 105 of 184 patients with a PSADT of <24 months. The PSA non-recurrence rate at 5 years for patients with a preoperative PSADT of >24 months was significantly better compared with those with a preoperative PSADT of <24 months (P=0.011). Patients with a PSADT of >24 months and stable PSADT were associated with PSA recurrence following surgery, based on multivariate analysis. Postoperative PSADT was measured in 51 of 111 patients with PSA failure following surgery. Pathologically, 7 of 8 patients with a post-PSADT of >24 months had a cancer confined to the prostate compared with 14 of 43 patients with a post-PSADT of <24 months. These results suggest that patients with longer preoperative PSADTs appeared to have a favorable pathological result and a higher PSA non-recurrence rate compared with those with shorter preoperative PSADTs. A longer postoperative PSADT may facilitate the observation of patients with PSA recurrence without immediate secondary treatments.

View Figures

View References

1	Catalona WJ, Smith DS, Ratliff TL, Dodds KM, Coplen DE, Yuan JJJ, Petros JA and Andriole GL: Measurement of prostate-specific antigen in serum as a screening test for prostate cancer. N Engl J Med. 324:1156–1161. 1991. View Article : Google Scholar : PubMed/NCBI
2	Loeb S, Roehl KA, Helfand BT, Kan D and Catalona WJ: Can prostate specific antigen velocity thresholds decrease insignificant prostate cancer detection? J Urol. 183:112–116. 2010. View Article : Google Scholar : PubMed/NCBI
3	Carter HB, Morrell CH, Pearson JD, Brant LJ, Plato CC, Metter EJ, Chan DW, Fozard JL and Walsh PC: Estimation of prostatic growth using serial prostate-specific antigen measurements in men with and without prostate disease. Cancer Res. 52:3323–3328. 1992.PubMed/NCBI
4	Nam RK, Klotz LH, Jewett MAS, Danjoux C and Trachtenberg J: Prostate specific antigen velocity as a measure of the natural history of prostate cancer: Defining a ‘rapid riser’ subset. Br J Urol. 81:100–104. 1998. View Article : Google Scholar : PubMed/NCBI
5	D'Amico AV and Hanks GE: Linear regressive analysis using prostate-specific antigen doubling time for predicting tumor biology and clinical outcome in prostate cancer. Cancer. 72:2638–2643. 1993. View Article : Google Scholar : PubMed/NCBI
6	McLaren DB, McKenzie M, Duncan G and Pickles T: Watchful waiting or watchful progression?: Prostate specific antigen doubling times and clinical behavior in patients with early untreated prostate carcinoma. Cancer. 82:342–348. 1998. View Article : Google Scholar : PubMed/NCBI
7	Lee WR, Hanks GE, Corn BW and Schultheiss TE: Observations of pretreatment prostate-specific antigen doubling time in 107 patients referred for definitive radiotherapy. Int J Radiat Oncol Biol Phys. 31:21–24. 1995. View Article : Google Scholar : PubMed/NCBI
8	Goluboff ET, Heitjan DF, DeVries GM, Katz AE, Benson MC and Olsson CA: Pretreatment prostate specific antigen doubling times: Use in patients before radical prostatectomy. J Urol. 158:1876–1878; discussion 1878–1879. 1997. View Article : Google Scholar : PubMed/NCBI
9	Arlen PM, Bianco F, Dahut WL, D'Amico A, Figg WD, Freedland SJ, Gulley JL, Kantoff PW, Kattan MW, Lee A, et al: Prostate Specific Antigen Working Group: Prostate Specific Antigen Working Group guidelines on prostate specific antigen doubling time. J Urol. 179:2181–2185; discussion 2185–2186. 2008. View Article : Google Scholar : PubMed/NCBI
10	Egawa S, Matsumoto K, Suyama K, Iwamura M, Kuwao S and Baba S: Observations of prostate specific antigen doubling time in Japanese patients with nonmetastatic prostate carcinoma. Cancer. 86:463–469. 1999. View Article : Google Scholar : PubMed/NCBI
11	Gerber GS, Gornik HL, Goldfischer ER, Chodak GW and Rukstalis DB: Evaluation of changes in prostate specific antigen in clinically localized prostate cancer managed without initial therapy. J Urol. 159:1243–1246. 1998. View Article : Google Scholar : PubMed/NCBI
12	Smith MR, Kabbinavar F, Saad F, Hussain A, Gittelman MC, Bilhartz DL, Wynne C, Murray R, Zinner NR, Schulman C, et al: Natural history of rising serum prostate-specific antigen in men with castrate nonmetastatic prostate cancer. J Clin Oncol. 23:2918–2925. 2005. View Article : Google Scholar : PubMed/NCBI
13	Schmid H-P, McNeal JE and Stamey TA: Observations on the doubling time of prostate cancer. The use of serial prostate-specific antigen in patients with untreated disease as a measure of increasing cancer volume. Cancer. 71:2031–2040. 1993. View Article : Google Scholar : PubMed/NCBI
14	Hanks GE, Hanlon AL, Lee WR, Slivjak A and Schultheiss TE: Pretreatment prostate-specific antigen doubling times: Clinical utility of this predictor of prostate cancer behavior. Int J Radiat Oncol Biol Phys. 34:549–553. 1996. View Article : Google Scholar : PubMed/NCBI
15	Sandler HM, Dunn RL, McLaughlin PW, Hayman JA, Sullivan MA and Taylor JM: Overall survival after prostate-specific-antigen-detected recurrence following conformal radiation therapy. Int J Radiat Oncol Biol Phys. 48:629–633. 2000. View Article : Google Scholar : PubMed/NCBI
16	Loberg RD, Fielhauer JR, Pienta BA, Dresden S, Christmas P, Kalikin LM, Olson KB and Pienta KJ: Prostate-specific antigen doubling time and survival in patients with advanced metastatic prostate cancer. Urology 62 (Suppl 1). 128–133. 2003. View Article : Google Scholar
17	Semeniuk RC, Venner PM and North S: Prostate-specific antigen doubling time is associated with survival in men with hormone-refractory prostate cancer. Urology. 68:565–569. 2006. View Article : Google Scholar : PubMed/NCBI
18	Shulman MJ, Karam JA and Benaim EA: Prostate-specific antigen doubling time predicts response to deferred antiandrogen therapy in men with androgen-independent prostate cancer. Urology. 63:732–736. 2004. View Article : Google Scholar : PubMed/NCBI
19	D'Amico AV, Moul JW, Carroll PR, Sun L, Lubeck D and Chen MH: Surrogate end point for prostate cancer-specific mortality after radical prostatectomy or radiation therapy. J Natl Cancer Inst. 95:1376–1383. 2003. View Article : Google Scholar : PubMed/NCBI
20	Egawa S, Arai Y, Tobisu K, Kuwao S, Kamoto T, Kakehi Y and Baba S: Use of pretreatment prostate-specific antigen doubling time to predict outcome after radical prostatectomy. Prostate Cancer Prostatic Dis. 3:269–274. 2000. View Article : Google Scholar : PubMed/NCBI
21	Freedland SJ, Humphreys EB, Mangold LA, Eisenberger M, Dorey FJ, Walsh PC and Partin AW: Risk of prostate cancer-specific mortality following biochemical recurrence after radical prostatectomy. JAMA. 294:433–439. 2005. View Article : Google Scholar : PubMed/NCBI