According to results recently presented at the 2004 annual meeting of the American Urological Association, the time it takes for a patient’s PSA level to double is a factor in predicting survival following surgery in patients with localized prostate cancer.
Prostate cancer is the most common cancer diagnosed in men in the United States, ultimately taking the lives of nearly 30,000 men annually. The prostate is a walnut-sized gland that is located between the bladder and rectum, and is responsible for forming a portion of semen. Patients with early prostate cancer, or cancer that has not extended past the prostate, are often treated with surgery to remove the prostate and surrounding tissue, referred to as a radical prostatectomy. Although long-term survival is high following a radical prostatectomy for early-stage prostate cancer, some patients will ultimately develop disease that has spread to distant sites in the body following surgery and will die from prostate cancer. Researchers are trying to determine an association between characteristics of the cancer and/or patient and the development of advanced disease or death, so that patients at a higher risk of a cancer recurrence may be treated in a more aggressive manner to improve long-term outcomes.
Researchers from Baltimore, Maryland recently conducted a clinical study to evaluate different cancer characteristics and associated outcomes in patients with prostate cancer. This study included nearly 6,000 men who had been diagnosed with early prostate cancer and had been treated with a radical prostatectomy since 1982. Previous data from this trial indicated that the duration of time that it took for a patient’s PSA level to double was strongly associated with the progression of their cancer. Following a prostatectomy, patients who had a PSA doubling time of less than 10 months had a significantly stronger likelihood to develop advanced cancer compared to those whose PSA doubling time was less than 10 months. The researchers extended their review to evaluate associations such as PSA and treatment history and its potential effect on survival in the same group of men. At over 8 years of follow-up, the researchers discovered that PSA doubling time also effected survival in these patients. In the group of patients with a PSA doubling time of less than 10 months following a prostatectomy, 42% of patients died from prostate cancer. Conversely, in the group of patients who had a PSA doubling time of greater than 10 months, only 7% of patients died from prostate cancer.
Reference: Partin A, Humphreys E, Mangold L, et al. Prostate specific antigen doubling time after radical prostatectomy as a predictor of cause specific survival. Proceedings from the 99th annual meeting of the American Urological Association. 2004;171:Abstract #1451.