Can prostate specific antigen derivatives and pathological parameters predict significant change in expectant management criteria for prostate cancer?

Masood A. Khan, H Ballentine Carter, Jonathan Ira Epstein, Michael C. Miller, Patricia Landis, Patrick Walsh, Alan Wayne Partin, Robert W. Veltri

Research output: Contribution to journalArticle


Purpose: A prior report established that pretreatment criteria based on clinical and biopsy pathology parameters can predict men who harbor small volume prostate cancer who might be followed expectantly. However, some of these men will exhibit disease progression with time and will need definitive therapy. To detect those in whom disease may progress, repeat prostate biopsies are performed at yearly intervals. Therefore, we determined whether biomarkers could be used to determine those in whom disease is likely to progress and thus those who require definitive therapy. Materials and Methods: Initial and repeat biopsy information along with transrectal ultrasound measurements of gland volume, total prostate specific antigen (PSA), %free PSA (%fPSA) and total PSA velocity were evaluated in 78 men, 45 from the prior study, in whom disease was being managed expectantly. Univariate and multivariate logistic regression analyses determined variables that predicted a favorable tumor burden based on biopsy pathology status at each subsequent repeat biopsy. A Cox proportional hazards model was produced using 67 of 78 evaluable cases having adequate temporal data to predict hazard ratios for conversion from favorable to unfavorable tumor burden status. Results: At time zero for 78 patients %fPSA, total PSA, and gland volume univariately and multivariately differentiated unfavorable and favorable tumor burden groups (p

Original languageEnglish (US)
Pages (from-to)2274-2278
Number of pages5
JournalJournal of Urology
Issue number6 I
StatePublished - Dec 2003
Externally publishedYes



  • Adenocarcinoma
  • Analogs and derivatives
  • Prostate-specific antigen
  • Prostatic neoplasms
  • Therapy

ASJC Scopus subject areas

  • Urology

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