TY - JOUR
T1 - PSA repeatedly fluctuating levels are reassuring enough to avoid biopsy?
AU - Taverna, Gianluigi
AU - Grizzi, Fabio
AU - Minuti, Francesco
AU - Seveso, Mauro
AU - Piccinelli, Alessandro
AU - Giusti, Guido
AU - Benetti, Alessio
AU - Maugeri, Orazio
AU - Pasini, Luisa
AU - Zandegiacomo, Silvia
AU - Colombo, Piergiuseppe
AU - Di Biccari, Sonia
AU - Graziotti, Pierpaolo
PY - 2009/12
Y1 - 2009/12
N2 - 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.
AB - 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.
KW - Fluctuating PSA levels
KW - Prostate cancer
KW - PSA doubling time
KW - PSA slope
KW - PSA velocity
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M3 - Article
C2 - 20608141
AN - SCOPUS:76149094231
VL - 81
SP - 203
EP - 208
JO - Archivio Italiano di Urologia Nefrologia Andrologia
JF - Archivio Italiano di Urologia Nefrologia Andrologia
SN - 1120-8538
IS - 4
ER -