PSA repeatedly fluctuating levels are reassuring enough to avoid biopsy?

Gianluigi Taverna, Fabio Grizzi, Francesco Minuti, Mauro Seveso, Alessandro Piccinelli, Guido Giusti, Alessio Benetti, Orazio Maugeri, Luisa Pasini, Silvia Zandegiacomo, Piergiuseppe Colombo, Sonia Di Biccari, Pierpaolo Graziotti

Research output: Contribution to journalArticlepeer-review


Introduction: Prostate-specific antigen (PSA) levels can show wide fluctuations when repeatedly measured. Here we investigatewd if: a) biopsy timing influences the prostate cancer (PC) detection rate in patients with fluctuating PSA (flu-PSA) in comparison with patients with steadily increasing PSA (si-PSA); b) PSA slope estimated in patients with flu-PSA predicts a different risk of cancer detection; c) flu-PSA and si-PSA patients develop PC in topographically different sites; d) the behaviour of pre-operative PSA is an expression oj a disease with different characteristics to the following radical prostatectomy. Methods: The study involved 211 patients who underwent at least a second biopsy after a first negative prostate biopsy. PSA Slope, PSA velocity (PSAV) and PSA doubling time (PSADT) were estimated. Flu-PSA level was defined as a PSA series with at least one PSA value lower than the one immediately preceding it. Results: 82 patients had flu-PSA levels and 129 si-PSA levels. There were no significant differences between the two groups in terms of cancer detection, clinical or pathological stage, but the si-PSA group with cancer had a higher Gleason score. No difference was found for PSA Slope between flu-PSA patients with cancer and those without. Conclusions: Our study demonstrates no difference in PC detection rate at repeat biopsy between patients with flu or si-PSA levels. PSA Slope, PSAV, and PSADT were not found helpful tools in cancer detection.

Original languageEnglish
Pages (from-to)203-208
Number of pages6
JournalArchivio Italiano di Urologia e Andrologia
Issue number4
Publication statusPublished - Dec 2009


  • Fluctuating PSA levels
  • Prostate cancer
  • PSA doubling time
  • PSA slope
  • PSA velocity

ASJC Scopus subject areas

  • Urology

Fingerprint Dive into the research topics of 'PSA repeatedly fluctuating levels are reassuring enough to avoid biopsy?'. Together they form a unique fingerprint.

Cite this