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A New Technique for Treating Low-risk Prostate Cancer—Super Active Surveillance
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Is prostate-specific antigen percentage decrease predictive of clinical outcome after permanent iodine-125

Mauro Paoluzzi1, Marcello Mignogna, Elena Lorenzini

  • 1Operative Unit of Urology, Campo di Marte Hospital, ASL 2 Lucca, Italy. mpaoluzzi@usl2.toscana.it

Brachytherapy
|December 6, 2011
PubMed
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A prostate-specific antigen (PSA) percentage over 20% at six months post-treatment can predict biochemical relapse after brachytherapy for prostate cancer. This simple PSA measurement offers an early indicator of poor outcomes in patients undergoing this treatment.

Area of Science:

  • Oncology
  • Urology
  • Radiotherapy

Background:

  • Prostate-specific antigen (PSA) is crucial for monitoring prostate cancer patients post-treatment.
  • Traditional PSA monitoring can be influenced by initial PSA levels and prostate volume.
  • Predicting biochemical relapse early after brachytherapy is essential for timely intervention.

Purpose of the Study:

  • To evaluate the utility of PSA percentage relative to pretreatment levels in predicting biochemical relapse after iodine-125 ((125)I) brachytherapy.
  • To identify a PSA-based parameter that is independent of initial PSA and prostate volume.

Main Methods:

  • A cohort of 133 prostate cancer patients treated with (125)I brachytherapy was analyzed.
  • PSA levels before and after treatment were recorded; PSA percentage was calculated.

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  • Statistical analyses included Cox regression, ROC curves, and Kaplan-Meier analysis.

    • Main Results:

    • A PSA percentage >20% of the pretreatment value was significantly associated with an increased risk of relapse (p<0.0001).
    • This association was evident as early as 6 months post-treatment.
    • The predictive cutoff of 20% demonstrated a hazard ratio of 4.965, with 72.4% sensitivity and 79.8% specificity.

    Conclusions:

    • PSA percentage >20% at 6 months after brachytherapy is a strong predictor of biochemical relapse.
    • This method offers an early, cost-effective, and valuable tool for identifying patients at high risk of poor outcomes.
    • The PSA percentage parameter overcomes limitations associated with absolute PSA values and prostate volume.