Prostate Specific Antigen Predicts the Long-Term Risk of Prostate Enlargement: Results from the Baltimore Longitudinal Study of Aging
2002; Lippincott Williams & Wilkins; Volume: 167; Issue: 6 Linguagem: Inglês
10.1016/s0022-5347(05)65010-0
ISSN1527-3792
AutoresE. James Wright, Junyong Fang, E. Jeffrey Metter, Alan W. Partin, Patricia Landis, Daniel W. Chan, H. Ballentine Carter,
Tópico(s)Pelvic floor disorders treatments
ResumoNo AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Jun 2002Prostate Specific Antigen Predicts the Long-Term Risk of Prostate Enlargement: Results from the Baltimore Longitudinal Study of Aging E. JAMES WRIGHT, JUNYONG FANG, E. JEFFREY METTER, ALAN W. PARTIN, PATRICIA LANDIS, DANIEL W. CHAN, and H. BALLENTINE CARTER E. JAMES WRIGHTE. JAMES WRIGHT , JUNYONG FANGJUNYONG FANG , E. JEFFREY METTERE. JEFFREY METTER , ALAN W. PARTINALAN W. PARTIN , PATRICIA LANDISPATRICIA LANDIS , DANIEL W. CHANDANIEL W. CHAN , and H. BALLENTINE CARTERH. BALLENTINE CARTER View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)65010-0AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Prostate specific antigen (PSA) is a predictor of prostate growth in men with lower urinary tract symptoms. The long-term risk of prostate enlargement as a function of PSA among community dwelling volunteers is unknown. Materials and Methods: A Cox proportional hazards regression model was used to study the relationship between baseline PSA level at ages 40 to 49.9 years in 194 men, 50 to 59.9 in 191 and 60 to 69.9 in 144, and prostate enlargement, defined as a prostate volume larger than the 75th percentile for age decade, as measured by magnetic resonance imaging in a longitudinal study of aging (Baltimore Longitudinal Study of Aging, National Institute on Aging). Kaplan-Meier survival analysis was performed to estimate the probability of freedom from prostate enlargement with time as a function of baseline PSA level. Results: The relative risk of prostate enlargement was 3- to 6-fold higher for men 40 to 49.9 years old with a baseline PSA of 0.31 ng./ml. or more compared to men with PSA levels of 0.30 ng./ml. or less at baseline. The relative risk was increased 5- to 9-fold in men 50 to 59.9 years old and 11-fold in those 60 to 69.9 years old when comparing men with PSA greater than 0.80 ng./ml. and greater than 1.70 ng./ml. with those with PSA 0.50 or less. The cumulative probability of freedom from prostate enlargement at 20 years was 0.89 (95% confidence interval ([CI] 0.79–0.99) and 0.63 (0.52–0.74) for men 40 to 49.9 years old with PSA levels below and above 0.30 ng./ml., respectively. For men 50 to 59.9 years old the 10-year probability of freedom from prostate enlargement was 0.90 (95% CI 0.84–0.96) and 0.59 (0.43–0.74) when PSA levels were below and above 0.80 ng./ml., respectively. At age 60 to 69.9 years the 10-year probability of freedom from prostate enlargement was 0.83 (95% CI 0.72–0.93) and 0.27 (0.09 to 0.48) when PSA levels were below and above 1.70 ng./ml., respectively. Conclusions: These data demonstrate the long-term risk of prostate enlargement by PSA level. Risk stratification based on PSA level may be useful to identify men at greatest risk for adverse events due to prostate enlargement and selection of men for future benign prostatic hyperplasia studies. References 1 : Do prostate size and urinary flow rates predict health care-seeking behavior for urinary symptoms in men?. Urology1995; 45: 64. Google Scholar 2 : Natural history of prostatism: risk factors for acute urinary retention. J Urol1997; 158: 481. Link, Google Scholar 3 : Serum prostate-specific antigen concentration is a powerful predictor of acute urinary retention and need for surgery in men with clinical benign prostatic hyperplasia. Urology1999; 53: 473. Google Scholar 4 : Serum prostate specific antigen is a strong predictor of future prostate growth in men with benign prostatic hyperplasia. J Urol2000; 163: 13. Link, Google Scholar 5 Shock, N.W., Greulich, R.C., Andres, R., et al.: Normal Human Aging: The Baltimore Longitudinal Study of Aging, November 1984. 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Google Scholar From the Departments of Urology and Pathology, The Johns Hopkins University School of Medicine, The James Buchanan Brady Urological Institute, The Johns Hopkins Hospital, National Institute on Aging, National Institutes of Health and Gerontology Research Center, Baltimore, Maryland© 2002 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byLoeb S, Kettermann A, Carter H, Ferrucci L, Metter E and Walsh P (2018) Prostate Volume Changes Over Time: Results From the Baltimore Longitudinal Study of AgingJournal of Urology, VOL. 182, NO. 4, (1458-1462), Online publication date: 1-Oct-2009.Latchamsetty K, Kim J and Porter C (2018) Prostate Specific Antigen Remains an Independent Predictor of Cancer at Prostate Biopsy in Black American Men But Not in White Men: Results from a Consecutive Series of 914 MenJournal of Urology, VOL. 175, NO. 3, (913-917), Online publication date: 1-Mar-2006.Mitchell R, Desai M, Shah J, Olsson C, Benson M and McKiernan J (2018) Preoperative Serum Prostate Specific Antigen Remains a Significant Prognostic Variable in Predicting Biochemical Failure After Radical ProstatectomyJournal of Urology, VOL. 175, NO. 5, (1663-1667), Online publication date: 1-May-2006.Marks L, Roehrborn C and Andriole G (2018) Prevention of Benign Prostatic Hyperplasia DiseaseJournal of Urology, VOL. 176, NO. 4, (1299-1306), Online publication date: 1-Oct-2006.CARTER H, LANDIS P, WRIGHT E, PARSONS J and METTER E (2018) CAN A BASELINE PROSTATE SPECIFIC ANTIGEN LEVEL IDENTIFY MEN WHO WILL HAVE LOWER URINARY TRACT SYMPTOMS LATER IN LIFE?Journal of Urology, VOL. 173, NO. 6, (2040-2043), Online publication date: 1-Jun-2005. Volume 167Issue 6June 2002Page: 2484-2487 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.Keywordsprostate-specific antigenprostatic hyperplasiaprostateMetricsAuthor Information E. JAMES WRIGHT More articles by this author JUNYONG FANG More articles by this author E. JEFFREY METTER More articles by this author ALAN W. PARTIN More articles by this author PATRICIA LANDIS More articles by this author DANIEL W. CHAN More articles by this author H. BALLENTINE CARTER More articles by this author Expand All Advertisement PDF downloadLoading ...
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