TY - JOUR
T1 - PSA Doubling Time Versus PSA Velocity to Predict High-Risk Prostate Cancer
T2 - Data from the Baltimore Longitudinal Study of Aging
AU - Loeb, Stacy
AU - Kettermann, Anna
AU - Ferrucci, Luigi
AU - Landis, Patricia
AU - Metter, E. Jeffrey
AU - Carter, H. Ballentine
N1 - Funding Information:
Funding/Support and role of the sponsor : This research was supported by the Intramural Research Program of the US National Institutes of Health, National Institute on Aging.
PY - 2008/11
Y1 - 2008/11
N2 - 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.
AB - 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.
KW - PSA doubling time
KW - PSA kinetics
KW - PSA velocity
KW - Prognosis
KW - Prostate cancer
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U2 - 10.1016/j.eururo.2008.06.076
DO - 10.1016/j.eururo.2008.06.076
M3 - Article
C2 - 18614274
AN - SCOPUS:55649123911
SN - 0302-2838
VL - 54
SP - 1073
EP - 1080
JO - European Urology
JF - European Urology
IS - 5
ER -