Rise in serum PSA of 1.5 ng/mL above 24-month nadir after external beam radiotherapy is predictive of biochemical failure

Ashish Kamat, Charles J. Rosser, Lawrence B. Levy, Ramsey Chichakli, Andrew K. Lee, Min Rex Cheung, Louis L Pisters

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Abstract

Objectives To determine whether a rise in the serum prostate-specific antigen (PSA) concentration 24 months or later after completion of external beam radiotherapy (EBRT) for prostate cancer could predict for biochemical failure. Methods We evaluated the records of 1006 patients who had undergone full-dose EBRT alone as primary treatment for T1-T4NxM0 prostate cancer at our institution between April 1987 and January 1998. Patients who had biochemical failure - as determined by the American Society for Therapeutic Radiology and Oncology (ASTRO) definition - prior to 24 months after EBRT were excluded. PSA increases of four different magnitudes (0.5, 0.8, 1.0, and 1.5 ng/mL above the 24-month nadir) were evaluated for their ability to predict ASTRO-defined biochemical failure. Results A total of 745 patients met the analysis criteria. The rate of ASTRO-defined biochemical failure in patients with a PSA increase of 0.5, 0.8, 1.0, and 1.5 ng/mL above the 24-month nadir was 56%, 64%, 66%, and 71%, respectively. An increase of 1.5 ng/mL or more had a sensitivity of 80% and a specificity of 88% in the prediction of biochemical failure, with an accuracy of 86%. Conclusions A PSA increase of 1.5 ng/mL or more above the 24-month nadir can be used to predict for ASTRO-defined failure after EBRT and may be used to identify patients at risk early-on.

Original languageEnglish (US)
Pages (from-to)1132-1137
Number of pages6
JournalUrology
Volume63
Issue number6
DOIs
StatePublished - Jun 1 2004

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Prostate-Specific Antigen
Radiotherapy
Radiation Oncology
Serum
Prostatic Neoplasms
Therapeutics

ASJC Scopus subject areas

  • Urology

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Rise in serum PSA of 1.5 ng/mL above 24-month nadir after external beam radiotherapy is predictive of biochemical failure. / Kamat, Ashish; Rosser, Charles J.; Levy, Lawrence B.; Chichakli, Ramsey; Lee, Andrew K.; Cheung, Min Rex; Pisters, Louis L.

In: Urology, Vol. 63, No. 6, 01.06.2004, p. 1132-1137.

Research output: Contribution to journalArticle

Kamat, Ashish ; Rosser, Charles J. ; Levy, Lawrence B. ; Chichakli, Ramsey ; Lee, Andrew K. ; Cheung, Min Rex ; Pisters, Louis L. / Rise in serum PSA of 1.5 ng/mL above 24-month nadir after external beam radiotherapy is predictive of biochemical failure. In: Urology. 2004 ; Vol. 63, No. 6. pp. 1132-1137.
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abstract = "Objectives To determine whether a rise in the serum prostate-specific antigen (PSA) concentration 24 months or later after completion of external beam radiotherapy (EBRT) for prostate cancer could predict for biochemical failure. Methods We evaluated the records of 1006 patients who had undergone full-dose EBRT alone as primary treatment for T1-T4NxM0 prostate cancer at our institution between April 1987 and January 1998. Patients who had biochemical failure - as determined by the American Society for Therapeutic Radiology and Oncology (ASTRO) definition - prior to 24 months after EBRT were excluded. PSA increases of four different magnitudes (0.5, 0.8, 1.0, and 1.5 ng/mL above the 24-month nadir) were evaluated for their ability to predict ASTRO-defined biochemical failure. Results A total of 745 patients met the analysis criteria. The rate of ASTRO-defined biochemical failure in patients with a PSA increase of 0.5, 0.8, 1.0, and 1.5 ng/mL above the 24-month nadir was 56{\%}, 64{\%}, 66{\%}, and 71{\%}, respectively. An increase of 1.5 ng/mL or more had a sensitivity of 80{\%} and a specificity of 88{\%} in the prediction of biochemical failure, with an accuracy of 86{\%}. Conclusions A PSA increase of 1.5 ng/mL or more above the 24-month nadir can be used to predict for ASTRO-defined failure after EBRT and may be used to identify patients at risk early-on.",
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T1 - Rise in serum PSA of 1.5 ng/mL above 24-month nadir after external beam radiotherapy is predictive of biochemical failure

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AU - Rosser, Charles J.

AU - Levy, Lawrence B.

AU - Chichakli, Ramsey

AU - Lee, Andrew K.

AU - Cheung, Min Rex

AU - Pisters, Louis L

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N2 - Objectives To determine whether a rise in the serum prostate-specific antigen (PSA) concentration 24 months or later after completion of external beam radiotherapy (EBRT) for prostate cancer could predict for biochemical failure. Methods We evaluated the records of 1006 patients who had undergone full-dose EBRT alone as primary treatment for T1-T4NxM0 prostate cancer at our institution between April 1987 and January 1998. Patients who had biochemical failure - as determined by the American Society for Therapeutic Radiology and Oncology (ASTRO) definition - prior to 24 months after EBRT were excluded. PSA increases of four different magnitudes (0.5, 0.8, 1.0, and 1.5 ng/mL above the 24-month nadir) were evaluated for their ability to predict ASTRO-defined biochemical failure. Results A total of 745 patients met the analysis criteria. The rate of ASTRO-defined biochemical failure in patients with a PSA increase of 0.5, 0.8, 1.0, and 1.5 ng/mL above the 24-month nadir was 56%, 64%, 66%, and 71%, respectively. An increase of 1.5 ng/mL or more had a sensitivity of 80% and a specificity of 88% in the prediction of biochemical failure, with an accuracy of 86%. Conclusions A PSA increase of 1.5 ng/mL or more above the 24-month nadir can be used to predict for ASTRO-defined failure after EBRT and may be used to identify patients at risk early-on.

AB - Objectives To determine whether a rise in the serum prostate-specific antigen (PSA) concentration 24 months or later after completion of external beam radiotherapy (EBRT) for prostate cancer could predict for biochemical failure. Methods We evaluated the records of 1006 patients who had undergone full-dose EBRT alone as primary treatment for T1-T4NxM0 prostate cancer at our institution between April 1987 and January 1998. Patients who had biochemical failure - as determined by the American Society for Therapeutic Radiology and Oncology (ASTRO) definition - prior to 24 months after EBRT were excluded. PSA increases of four different magnitudes (0.5, 0.8, 1.0, and 1.5 ng/mL above the 24-month nadir) were evaluated for their ability to predict ASTRO-defined biochemical failure. Results A total of 745 patients met the analysis criteria. The rate of ASTRO-defined biochemical failure in patients with a PSA increase of 0.5, 0.8, 1.0, and 1.5 ng/mL above the 24-month nadir was 56%, 64%, 66%, and 71%, respectively. An increase of 1.5 ng/mL or more had a sensitivity of 80% and a specificity of 88% in the prediction of biochemical failure, with an accuracy of 86%. Conclusions A PSA increase of 1.5 ng/mL or more above the 24-month nadir can be used to predict for ASTRO-defined failure after EBRT and may be used to identify patients at risk early-on.

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