Prostate-Specific Antigen Kinetics Following 5α-Reductase Inhibitor Treatment May Be a Useful Indicator for Repeat Prostate Biopsy
Yonsei Medical Journal
;
: 219-225, 2018.
Article
in English
| WPRIM
| ID: wpr-713100
ABSTRACT
PURPOSE:
To evaluate parameters for determining repeat prostate biopsy in patients with 5α-reductase inhibitor (5ARI) treatment after initial negative biopsy. MATERIALS ANDMETHODS:
From January 2007 to December 2015, patients who underwent a repeat prostate biopsy after an initial negative biopsy were enrolled from multiple institutions. Serial prostate-specific antigen (PSA) levels after the initial biopsy were analyzed for PSA kinetics. Clinicopathologic variables were evaluated according to the use of 5ARIs after the initial negative biopsy.RESULTS:
Of 419 patients with initial negative biopsies (median age=67.0 years, median PSA=6.31 ng/mL), 101 patients (24.1%) were diagnosed with prostate cancer at the repeat biopsy. An increase in PSA level at 18 months, compared to that at 6 months, was a predictor of a positive repeat biopsy. However, the use of 5ARIs was not identified as a predictor. Of 126 patients receiving 5ARI treatment after the initial biopsy, 30 (23.8%) were diagnosed with prostate cancer at the repeat biopsy. Increase in PSA level at more than two time points after 6 months of 5ARI treatment (odds ratio=4.84, p=0.005) was associated with cancer detection at the repeat biopsy. There were no significant 5ARI group-related differences in the detection rates of prostate and high-grade cancers (Gleason score ≥7).CONCLUSION:
The effects of 5ARIs on prostate cancer detection and chemoprevention remain uncertain. However, more than two increases in PSA level after 6 months of 5ARI treatment may indicate the presence of prostate cancer.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Prostatic Neoplasms
/
Biopsy
/
Kinetics
/
Predictive Value of Tests
/
Follow-Up Studies
/
Prostate-Specific Antigen
/
5-alpha Reductase Inhibitors
/
Neoplasm Grading
Type of study:
Observational study
/
Prognostic study
Limits:
Aged
/
Humans
/
Male
Language:
English
Journal:
Yonsei Medical Journal
Year:
2018
Type:
Article
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