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Evaluation of changes in prostate specific antigen in clinically localized prostate cancer managed without initial
G S Gerber1, H L Gornik, E R Goldfischer
1Department of Surgery, University of Chicago Pritzker School of Medicine, Illinois, USA.
The Journal of Urology
|March 21, 1998
Summary
Prostate specific antigen (PSA) levels vary significantly over time in untreated prostate cancer patients. Serial PSA measurements may not be useful for guiding treatment decisions during watchful waiting.
Area of Science:
- Urology
- Oncology
Background:
- Prostate cancer management often involves monitoring prostate-specific antigen (PSA) levels.
- Watchful waiting is a strategy for clinically localized prostate cancer, requiring careful patient monitoring.
Purpose of the Study:
- To analyze changes in prostate-specific antigen (PSA) over time in untreated men with localized prostate cancer.
- To assess the variability and predictability of PSA velocity in this patient cohort.
Main Methods:
- Retrospective analysis of PSA levels in 49 men managed with watchful waiting.
- PSA velocity determined using a log-linear model with at least three measurements at 6-month intervals.
- Correlation analysis between PSA velocity and clinical factors (age, Gleason sum, stage, initial PSA).
Main Results:
- Mean PSA follow-up was 32.1 months; 22% of patients showed decreased PSA levels.
- Median PSA doubling time was 55.7 months for patients with increasing PSA.
- No significant correlation found between PSA velocity and age, Gleason sum, initial PSA, or clinical stage.
Conclusions:
- Significant variability exists in PSA change over time for untreated localized prostate cancer.
- The utility of serial PSA measurements for guiding therapy decisions in watchful waiting is uncertain.
- PSA changes alone may not be sufficient for determining the need for treatment after observation.