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Clinical use of Prostate Specific Antigen in Patients with Prostate Cancer

1989; Lippincott Williams & Wilkins; Volume: 142; Issue: 4 Linguagem: Inglês

10.1016/s0022-5347(17)38972-3

1527-3792

M’Liss A. Hudson, Robert R. Bahnson, William J. Catàlona,

Prostate Cancer Diagnosis and Treatment

No AccessJournal of Urology1 Oct 1989Clinical use of Prostate Specific Antigen in Patients with Prostate Cancer M’liss A. Hudson, Robert R. Bahnson, and William J. Catalona M’liss A. HudsonM’liss A. Hudson Recipient of American Urological Association American Foundation for Urologic Disease Scholarship 1988–1990. More articles by this author , Robert R. BahnsonRobert R. Bahnson Recipient of American Cancer Society Clinical Oncology Career Development Award 86–48. Current address: Division of Urologic Surgery, University of Pittsburgh School of Medicine, Presbyterian University Hospital, Pittsburgh, Pennsylvania 15213. More articles by this author , and William J. CatalonaWilliam J. Catalona More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)38972-3AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail The clinical use of prostate specific antigen as a screening test for prostate cancer, as a preoperative determinant for staging of prostate cancer and to monitor response to therapy in prostatic cancer patients was evaluated in 168 men with benign prostatic hyperplasia and 231 men with prostate cancer. Only 3% of the men with benign prostatic hyperplasia had prostate specific antigen levels greater than 10ng. per ml. compared to 44% of the men with proved prostate cancer. Preoperative prostate specific antigen levels increased with higher clinical stages of prostate cancer but there was substantial overlap among stages. Among patients with stage Al prostate cancer who were followed expectantly none had an elevated prostate specific antigen value or metastatic disease during a followup of 15 to 120 months. After radical prostatectomy serum prostate specific antigen values decreased to undetectable levels (less than 0.6ng. per ml.) in 89% of the patients with organconfined disease, in 87% of those with microscopically positive margins only but in only 34% with seminal vesicles or lymph node involvement. Failure of the prostate specific antigen levels to decrease to the undetectable range after radical prostatectomy was associated with a greater likelihood of subsequent tumor recurrence. Only 3 of 18 patients (17%) treated with definitive radiation therapy had post-irradiation prostate specific antigen values of less than 0.6ng. per ml., while in 39% the prostate specific antigens values remained greater than 4ng. per ml. and in 4 of 18 (22%) the values were greater than 10ng. per ml. Of patients with previously untreated stage D2 prostate cancer the mean pre-treatment prostate specific antigen value was 63.7ng. per ml. compared to a post-hormonal therapy mean value of 31.1ng. per ml. Of 32 patients treated with hormonal therapy 14 had stable disease, including 13 with prostate specific antigen levels of less than 10ng. per ml. In contrast, 18 patients had progressive disease, of whom 16 had prostate specific antigen levels of more than 10ng. per ml. We conclude that the serum prostate specific antigen assay is most useful clinically to monitor the response to therapy of prostate cancer patients. (J. Urol., 142: 1011–1017, 1989) © 1989 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byKang J, Reiter R, Steinberg M and King C (2018) Ultrasensitive Prostate Specific Antigen after Prostatectomy Reliably Identifies Patients Requiring Postoperative RadiotherapyJournal of Urology, VOL. 193, NO. 5, (1532-1538), Online publication date: 1-May-2015.Thompson I, Ankerst D, Etzioni R and Wang T (2018) It's Time to Abandon an Upper Limit of Normal for Prostate Specific Antigen: Assessing the Risk of Prostate CancerJournal of Urology, VOL. 180, NO. 4, (1219-1222), Online publication date: 1-Oct-2008.DJAVAN B, WALDERT M, ZLOTTA A, DOBRONSKI P, SEITZ C, REMZI M, BORKOWSKI A, SCHULMAN C and MARBERGER M (2018) SAFETY AND MORBIDITY OF FIRST AND REPEAT TRANSRECTAL ULTRASOUND GUIDED PROSTATE NEEDLE BIOPSIES: RESULTS OF A PROSPECTIVE EUROPEAN PROSTATE CANCER DETECTION STUDYJournal of Urology, VOL. 166, NO. 3, (856-860), Online publication date: 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Feero, J. C. Nickel, P. Brown and I. Young, J. Urol., 143: 367–368, 1990Journal of Urology, VOL. 144, NO. 6, (1485-1485), Online publication date: 1-Dec-1990.Hudson M and Catalona W (2018) Effect of Adjuvant Radiation Therapy on Prostate Specific Antigen Following Radical ProstatectomyJournal of Urology, VOL. 143, NO. 6, (1174-1177), Online publication date: 1-Jun-1990.Catalona W (2018) Editorial CommentsJournal of Urology, VOL. 144, NO. 5, (1170-1171), Online publication date: 1-Nov-1990. Volume 142Issue 4October 1989Page: 1011-1017 Advertisement Copyright & Permissions© 1989 by The American Urological Association Education and Research, Inc.MetricsAuthor Information M’liss A. Hudson Recipient of American Urological Association American Foundation for Urologic Disease Scholarship 1988–1990. More articles by this author Robert R. Bahnson Recipient of American Cancer Society Clinical Oncology Career Development Award 86–48. Current address: Division of Urologic Surgery, University of Pittsburgh School of Medicine, Presbyterian University Hospital, Pittsburgh, Pennsylvania 15213. More articles by this author William J. Catalona More articles by this author Expand All Advertisement PDF downloadLoading ...