TY - JOUR
T1 - Correlation of initial PSA level and biopsy features with PSA-doubling time in early stage prostate cancers in Japanese men
AU - Kakehi, Yoshiyuki
AU - Kamoto, Toshiyuki
AU - Shiraishi, Taizo
AU - Kato, Tetsuro
AU - Tobisu, Ken ichi
AU - Akakura, Koichiro
AU - Egawa, Shin
AU - Maeda, Osamu
AU - Sumiyoshi, Yoshiteru
AU - Arai, Yoichi
AU - Ogawa, Osamu
N1 - Funding Information:
This work was supported by a Grant-in-Aid for Cancer Research from the Ministry of Health, Labour and Welfare of Japan (11–10).
PY - 2002
Y1 - 2002
N2 - Objective: To distinguish good candidates for watchful waiting from those who need immediate treatment in localized prostate cancer. Methods: Prostate specific antigen (PSA)-doubling time (DT) was calculated by a log-linear regression model for 78 patients with clinically localized prostate cancer (T1c: 47, T2a: 6, T2b: 21, and T3: 4) under surveillance. Median observation period was 37.5 months. The first 1-year PSA-DT was compared with the overall PSA-DT in 41 patients who had been under surveillance for more than 3 years. Results: There was significant difference in the PSA-DT distribution between a pooled group of T1c and T2a and a group of T2b and T3 patients (median 58.8 versus 33.3 months, P = 0.0052). A combination of three parameters consisting of initial PSA level less than 10 ng/ml, WHO grade 1, one or two positive core per six to eight systematic biopsy cores with 50% or less cancer involvement significantly correlated with PSA-DT distribution in the T1c plus T2a group (P = 0.0034). The first year assessment of PSA-DT was identical to the overall assessment in 48.8%, 2 years or more in 36.6%, while it was 2 years or less (possibly over-estimated) in 14.6%. Conclusion: PSA-DT can be predictable to some extent with the initial PSA level and biopsy features in early stage prostate cancers. Prospective study is needed to clarify whether temporary observation together with PSA-DT estimation is a safe strategy and is complementary to clinico-pathological parameters at diagnosis.
AB - Objective: To distinguish good candidates for watchful waiting from those who need immediate treatment in localized prostate cancer. Methods: Prostate specific antigen (PSA)-doubling time (DT) was calculated by a log-linear regression model for 78 patients with clinically localized prostate cancer (T1c: 47, T2a: 6, T2b: 21, and T3: 4) under surveillance. Median observation period was 37.5 months. The first 1-year PSA-DT was compared with the overall PSA-DT in 41 patients who had been under surveillance for more than 3 years. Results: There was significant difference in the PSA-DT distribution between a pooled group of T1c and T2a and a group of T2b and T3 patients (median 58.8 versus 33.3 months, P = 0.0052). A combination of three parameters consisting of initial PSA level less than 10 ng/ml, WHO grade 1, one or two positive core per six to eight systematic biopsy cores with 50% or less cancer involvement significantly correlated with PSA-DT distribution in the T1c plus T2a group (P = 0.0034). The first year assessment of PSA-DT was identical to the overall assessment in 48.8%, 2 years or more in 36.6%, while it was 2 years or less (possibly over-estimated) in 14.6%. Conclusion: PSA-DT can be predictable to some extent with the initial PSA level and biopsy features in early stage prostate cancers. Prospective study is needed to clarify whether temporary observation together with PSA-DT estimation is a safe strategy and is complementary to clinico-pathological parameters at diagnosis.
KW - Early stage prostate cancer
KW - PSA-doubling time
KW - PSA-era
KW - Watchful waiting
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U2 - 10.1016/S0302-2838(01)00020-3
DO - 10.1016/S0302-2838(01)00020-3
M3 - Article
C2 - 11999465
AN - SCOPUS:0036313616
VL - 41
SP - 47
EP - 53
JO - European Urology
JF - European Urology
SN - 0302-2838
IS - 1
ER -