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Eur Urol. 2008 Nov;54(5):1073-80. doi: 10.1016/j.eururo.2008.06.076. Epub 2008 Jul 2.

PSA doubling time versus PSA velocity to predict high-risk prostate cancer: data from the Baltimore Longitudinal Study of Aging.

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  • 1Department of Urology, The Johns Hopkins University School of Medicine, The James Buchanan Brady Urological Institute, The Johns Hopkins Hospital, Baltimore, Maryland 21287, USA. stacyloeb@gmail.com

Abstract

BACKGROUND:

Our group has previously shown that prostate-specific antigen (PSA) velocity (PSAV) is associated with the presence of life-threatening prostate cancer. Less is known about the relative utility of pretreatment PSA doubling time (PSA DT) to predict tumor aggressiveness.

OBJECTIVE:

To compare the utility of PSAV and PSA DT for the prediction of life-threatening prostate cancer.

DESIGN, SETTING, AND PARTICIPANTS:

From the Baltimore Longitudinal Study of Aging, we identified 681 men with serial PSA measurements.

MEASUREMENTS:

Receiver operating characteristic analysis was used to evaluate the relationship between PSAV, PSA DT, and the presence of high-risk disease.

RESULTS AND LIMITATIONS:

Within the period of 5 yr prior to diagnosis, PSAV was significantly higher among men with high-risk or fatal prostate cancer than men without it. By contrast, PSA DT was not significantly associated with high-risk or fatal disease. On multivariate analysis, including age, date of diagnosis, and PSA, the addition of PSAV significantly improved the concordance index from 0.85 to 0.88 (p<0.001), whereas PSA DT did not.

CONCLUSIONS:

These data suggest that PSAV is more useful than PSA DT in the pretreatment setting to help identify those men with life-threatening disease.

PMID:
18614274
[PubMed - indexed for MEDLINE]
PMCID:
PMC2582974
Free PMC Article
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