Use of prostate-specific antigen in the follow-up of patients with localized prostate cancer: Results of a nationwide survey of urologists

Urology ◽  
2006 ◽  
Vol 68 (1) ◽  
pp. 80-84 ◽  
Author(s):  
David Penson ◽  
Judd Moul ◽  
Sanjay Gandhi ◽  
Don Newling
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Nationwide Survey ◽  
Localized Prostate Cancer

Prostate-specific antigen as a predictor of radiotherapy response and patterns of failure in localized prostate cancer.

1992 ◽  
Vol 10 (8) ◽  
pp. 1208-1217 ◽  
Author(s):  
M A Ritter ◽  
E M Messing ◽  
T G Shanahan ◽  
S Potts ◽  
R J Chappell ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Prostatic Acid Phosphatase ◽  
Prognostic Indicator ◽  
Localized Prostate Cancer ◽  
External Beam Radiation ◽  
Beam Radiation ◽  
Metastatic Recurrence

PURPOSE A study of preradiation and postradiation, serial serum prostate-specific antigen (PSA) levels was performed in patients who had clinically localized prostate cancer. The prognostic value of the PSA in pretreatment evaluation and posttreatment follow-up was assessed. PATIENTS AND METHODS Sixty-three patients who presented with clinically localized prostate cancer and who were treated with external-beam radiation therapy were followed-up for a median of 25 months. A serum PSA and physical examination were performed at 3-month intervals, and a bone scan was done yearly. An increase in PSA triggered an additional metastatic workup. Prostate rebiopsy was performed for new, palpable nodules or for a serial increase in PSA in the context of a negative metastatic workup. RESULTS Forty-one patients remained recurrence-free and 22 recurred clinically, 15 distantly and seven locally. The PSA was the strongest, independent, pretreatment prognostic indicator (P = .019) among pretreatment PSA, stage, and grade, but lost significance when the serum prostatic acid phosphatase (PAP) status was included. The initial rate of the PSA decrease after radiation (median half-life, 2.6 months) failed to predict outcome. Recurrence-free patients reached postradiation PSA levels that were equivalent to those reported in disease-free male populations; failure of the PSA to reach such normal levels was a multivariate predictor of subsequent failure (P less than .037). All clinicopathologic documentations of failure were preceded by an increase in PSA levels during follow-up. Delayed versus early PSA increase was associated with clinically localized versus metastatic first recurrence. CONCLUSIONS The serum PSA is an independent pretreatment and posttreatment predictor of outcome. Additionally, for a median follow-up of 25 months, delayed PSA failure is associated with clinically localized rather than metastatic recurrence, a relationship that may help in selection for local salvage therapy.

scholarly journals Solitary Lung Metastasis of Prostate Cancer with a Long Disease-Free Interval and Normal Prostate-Specific Antigen Level

2021 ◽  
pp. 284-289
Author(s):  
Hiroyuki Yoshitake ◽  
Shoji Oura ◽  
Tomoyuki Yamaguchi ◽  
Shinichiro Makimoto
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Lung Metastasis ◽  
Specific Antigen ◽  
Middle Lobe ◽  
Primary Adenocarcinoma ◽  
Wide Resection ◽  
Normal Prostate ◽  
Solid Nodule

An 83-year-old man with core needle biopsy-proven Gleason score 5 prostate cancer had received radiotherapy including 18 Gy brachytherapy to the prostate cancer, leading to no locoregional and distant recurrence for more than 5 years with the normalization of elevated prostate-specific antigen (PSA) level before the radiotherapy. Due to the enlargement of coexisting ground glass nodule (GGN) in the left lung from 1 to 2.1 cm, the patient underwent wide resection of the GGN 7 years later. Under the diagnosis of adenocarcinoma in situ of the lung, follow-up computed tomography 6 months after the wide resection showed a rapid enlargement of a solid nodule having been judged as a presumed inflammatory nodule in the middle lobe, highly suggesting a malignant neoplasm of the lung. Due to both the tall columnar atypical cells with trabecular pattern on frozen section and no elevation of serum PSA level, we judged the nodule as a primary adenocarcinoma of the lung and further resected the middle lobe with lymph node dissection. Immunostaining of the tumor showed all the CK7, CK20, TTF-1, napsin A, synaptophysin, chromogranin, CD56, CDX2, p53, beta-catenin, and MUC2 negative, and PSA highly positive, clearly showing the solid nodule as a solitary lung metastasis of the prostate cancer. Physicians should note the possible solitary lung metastasis of prostate cancer, especially bearing indolent biology, with no elevation of the PSA level even after the completion of standard 5-year follow-up.

scholarly journals Early detection of prostate cancer local recurrence by urinary prostate-specific antigen

2013 ◽  
Vol 3 (3) ◽  
pp. 213 ◽  
Author(s):  
Stéphane Bolduc ◽  
Brant A. Inman ◽  
Louis Lacombe ◽  
Yves Fradet ◽  
Roland R. Tremblay
Keyword(s):  
Prostate Cancer ◽  
Early Detection ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Laboratory Assessment ◽  
Cross Sectional ◽  
Prostatectomie Radicale ◽  
Psa Recurrence ◽  
Patients Atteints De Cancer

Purpose: We assessed the role of urinary prostate-specific antigen(uPSA) in the follow-up of prostate cancer after retropubic radicalprostatectomy (RRP) for the early detection of local recurrences.Methods: We recruited 50 patients previously treated for prostatecancer with RRP and who had not experienced a prostatespecificantigen (PSA) recurrence within their first postoperativeyear into a cross-sectional laboratory assessment and prospective6-year longitudinal follow-up study. We defined biochemicalfailure as a serum PSA (sPSA) of 0.3 μg/L or greater. Patientsprovided blood samples and a 50-mL sample of first-voided urine.We performed Wilcoxon rank-sum and Fisher exact tests for statisticalanalysis.Results: The median sPSA was 0.13 μg/L. The median uPSA was0.8 μg/L, and was not significantly different when comparingGleason scores or pathological stages. Of the 50 patients, 27 initiallyhad a nondetectable sPSA but a detectable uPSA, and11 patients experienced sPSA failure after 6 years. Six patients haddetectable sPSA and uPSA initially. Fifteen patients were negativefor both sPSA and uPSA, and 13 remained sPSA-free after 6 years.The odds ratio (OR) of having sPSA failure given a positive uPSAtest was 4.5 if sPSA was undetectable, but was reduced to 2.6 ifsPSA was detectable. The pooled Mantel–Haenszel OR of 4.2 suggestedthat a detectable uPSA quadrupled the risk of recurrence,independent of whether sPSA was elevated or not. The sensitivityof uPSA for detecting future sPSA recurrences was 81% andspecificity was 45%.Conclusion: Urinary PSA could contribute to an early detection oflocal recurrences of prostate cancer after a radical prostatectomy.Objectif : Nous avons évalué le rôle de l’antigène prostatiquespécifique (APS) urinaire dans le suivi du cancer de la prostateaprès prostatectomie radicale rétropubienne (PRR) pour le dépistageprécoce de récidives locales.Méthodes : Cinquante patients atteints de cancer de la prostatetraités par PRR et n’ayant présenté aucune récidive avec anomaliede l’APS dans l’année suivant l’intervention chirurgicale ontété inscrits à une étude transversale par épreuves de laboratoireavec suivi longitudinal prospectif sur 6 ans. L’échec sur le planbiochimique était défini comme un taux d’APS sérique de 0,3 μg/Lou plus. Les patients devaient fournir des échantillons de sanget un échantillon d’urine du matin de 50 mL. Les analyses statistiquesreposaient sur le test de Wilcoxon et la méthode exactede Fisher.Résultats : La valeur médiane de l’APS sérique était de 0,13 μg/L.La valeur médiane de l’APS urinaire était de 0,8 μg/L; la différenceétait non significative quand on tenait compte des scores deGleason ou des stades pathologiques. Sur les 50 patients,27 présentaient des taux d’APS sérique non décelables au début,mais des taux d’APS urinaire décelables; 11 patients ont présentéun échec quant aux taux d’APS sérique après 6 ans. Six patientsavaient des taux d’APS sérique et urinaire décelables au départ.Quinze patients n’avaient aucun taux décelable d’APS sérique ouurinaire, et aucun APS sérique n’était toujours décelable chez13 patients après 6 ans. Le rapport de risque d’un échec quantaux taux d’APS sérique après détection d’APS urinaire est de 4,5en l’absence d’un taux d’APS sérique décelable, mais diminueà 2,6 en présence d’un taux d’APS sérique décelable. Le rapportde risque cumulé de 4,21 calculé par la méthode deMantel–Haenszel porte à croire que des taux d’APS urinaire décelablesquadruplent le risque de présenter une récidive, queles taux sériques soient élevés ou non. La sensibilité du test dedépistage de l’APS urinaire pour la détection des récidives avecanomalie des taux sériques était de 81 %, et la spécificité, de 45 %.Conclusion : Le taux d’APS urinaire peut contribuer à un dépistageprécoce des récidives locales après une prostatectomie radicale.

Role of ultrasensitive prostate-specific antigen in the follow-up of prostate cancer after radical prostatectomy

2015 ◽  
Vol 33 (1) ◽  
pp. 16.e1-16.e7 ◽  
Author(s):  
Heikki Seikkula ◽  
Kari T. Syvänen ◽  
Samu Kurki ◽  
Tuomas Mirtti ◽  
Pekka Taimen ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Prostate Specific Antigen ◽  
Specific Antigen
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