The prognostic effect of prostate-specific antigen half-life at the first follow-up visit in newly diagnosed metastatic prostate cancer

2015 ◽  
Vol 33 (9) ◽  
pp. 383.e17-383.e22 ◽  
Author(s):  
Ki Hong Kim ◽  
Kyung Seok Han ◽  
Kwang Hyun Kim ◽  
Dae Keun Kim ◽  
Kyo Chul Koo ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Half Life ◽  
Metastatic Prostate Cancer ◽  
Specific Antigen ◽  
Newly Diagnosed ◽  
Prognostic Effect

Tumor volume and prostate-specific antigen kinetics effects on outcomes of metastatic prostate cancer patients receiving androgen deprivation therapy

2020 ◽  
Author(s):  
Yen-Chi Lin ◽  
Po-Hung Lin ◽  
I-Hung Shao ◽  
Yuan-Cheng Chu ◽  
Hung-Cheng Kan ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Disease Progression ◽  
Prostate Specific Antigen ◽  
Androgen Deprivation Therapy ◽  
Metastatic Prostate Cancer ◽  
Tumor Volume ◽  
Specific Antigen ◽  
Newly Diagnosed ◽  
Psa Kinetics ◽  
Psa Nadir

Abstract Background The present study aimed to analyse the effects of androgen deprivation therapy (ADT) in patients with newly diagnosed metastatic castration-naïve prostate cancer (mCNPC) and explore predictors, particularly prostate-specific antigen (PSA) kinetics, associated with poor prognosis according to tumor volume, a new sub-classification of metastatic prostate cancer established by the CHAARTED trial.Methods We reviewed 648 patients with newly diagnosed mCNPC receiving ADT at Chang Gung Memorial Hospital from January 2007 to December 2016. Basic characteristics and PSA kinetics profile were subsequently evaluated.Results Among patients with high-volume disease, those with faster time to PSA nadir (TTN) (< 7 months), higher PSA nadir (≥ 2 ng/mL), and faster PSA doubling time (PSADT) (< 2 months) had higher risk for faster disease progression or shorter overall survival (OS) compared to those with slower TTN (> 7 months), lower PSA nadir (< 2 ng/mL), and slower PSADT (> 2 months). Multivariate analysis of those with low-volume disease showed that only PSADT (< 4 months) was tended to be associated with faster disease progression or shorter OS.Conclusions PSA kinetics are effective clinical predictors for risk of disease progression and survival. Moreover, various PSA kinetics should be monitored according to tumor volume.

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.

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