PSA Doubling Time Versus PSA Velocity to Predict High-Risk Prostate Cancer: Data from the Baltimore Longitudinal Study of Aging

Stacy Loeb, Anna Kettermann, Luigi Ferrucci, Patricia Landis, E. Jeffrey Metter, H. Ballentine Carter

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)1073-1080
Number of pages8
JournalEuropean Urology
Volume54
Issue number5
DOIs
StatePublished - Nov 1 2008

Keywords

  • PSA doubling time
  • PSA kinetics
  • PSA velocity
  • Prognosis
  • Prostate cancer

ASJC Scopus subject areas

  • Urology

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