Prediagnosis prostate specific antigen velocity is associated with risk of prostate cancer progression following brachytherapy and external beam radiation therapy Journal Article

  

Authors:	Eggener, S. E.; Roehl, K. A.; Yossepowitch, O.; Catalona, W. J.
Article Title:	Prediagnosis prostate specific antigen velocity is associated with risk of prostate cancer progression following brachytherapy and external beam radiation therapy
Abstract:	Purpose: Prostate specific antigen velocity 2.0 ng/ml per year or greater in the year before prostate cancer diagnosis is associated with cancer specific survival following radical prostatectomy and radiation therapy. We evaluated the relationship between prediagnosis prostate specific antigen velocity and cancer progression following primary radiation therapy. Materials and Methods: We analyzed the records of 24,893 men from a community based prostate cancer screening study and identified 237 with clinically localized prostate cancer who elected primary radiation therapy. Our final cohort consisted of 130 men, including 83 treated with external beam radiation and 47 treated with brachytherapy. Patient specific variables at diagnosis were analyzed for their value in predicting biochemical progression using American Society for Therapeutic and Radiation Oncology criteria. Results: Mean followup ± SD was 64 ± 35 months. Prostate specific antigen at diagnosis, family history of prostate cancer and prediagnosis prostate specific antigen velocity 2.0 ng/ml per year or greater were associated with cancer progression following brachytherapy or external beam radiation. Of men with prostate specific antigen velocity 2.0 ng/ml per year or greater 38% had cancer progression compared to 12% with prostate specific antigen velocity less than 2.0 ng/ml per year (OR 4.3, p = 0.003). The 6-year progression-free survival estimate was 57% in men with prostate specific antigen velocity 2.0 ng/ml per year or greater and 82% in men with prostate specific antigen velocity less than 2.0 ng/ml per year (p <0.001). On multivariate analysis absolute prostate specific antigen at diagnosis and prostate specific antigen velocity 2.0 ng/ml per year or greater were independently associated with cancer progression in men treated with external beam radiation therapy or brachytherapy. Conclusions: Men with a prediagnosis prostate specific antigen velocity of 2.0 ng/ml per year or greater are at increased risk for cancer progression following brachytherapy or external beam radiation compared to men with a prostate specific antigen velocity of less than 2.0 ng/ml per year. © 2006 American Urological Association.
Keywords:	adult; cancer survival; treatment outcome; aged; aged, 80 and over; disease-free survival; middle aged; major clinical study; cancer growth; disease free survival; follow up; follow-up studies; neoplasm staging; prostate specific antigen; radiotherapy; cancer screening; time factors; risk assessment; prostate cancer; prostate-specific antigen; prostatic neoplasms; prostate; antigen specificity; medical record; predictive value of tests; medical society; brachytherapy; multivariate analysis; external beam radiotherapy; time series analysis
Journal Title:	Journal of Urology
Volume:	176
Issue:	4
ISSN:	0022-5347
Publisher:	Elsevier Science, Inc.
Date Published:	2006-10-01
Start Page:	1399
End Page:	1403
Language:	English
DOI:	10.1016/j.juro.2006.06.045
PUBMED:	16952643
PROVIDER:	scopus
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-33748114143&partnerID=40&md5=e02cdf00509c348111f73f8fe771c8e4
Notes:	--- - "Cited By (since 1996): 12" - "Export Date: 4 June 2012" - "CODEN: JOURA" - "Source: Scopus"

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