Value of Prostate-Specific Antigen Kinetics in Patients with Low-Risk Prostate Cancer under Active Surveillance

Urol Int. 2023;107(7):706-712. doi: 10.1159/000530963. Epub 2023 Jun 16.

Abstract

Introduction: This study analyzes the value of PSA kinetics, PSA speed (vPSA), and PSA doubling time (PSAdt), in patients with low-risk prostate cancer who are in an active surveillance (AS) program.

Methods: An observational, retrospective, and longitudinal study of a sample of 86 patients included in AS program between January 2014 and October 2021 was conducted. A review of their medical records was performed, and PSA kinetics were calculated, analyzing the causes of discontinuation of the AS program and its relationship with PSA kinetics.

Results: The mean age was 63.39 years, and the median follow-up was 62.55 months. The mean PSA at diagnosis was 8.27 ng/mL. A median of PSAdt of 62.55 months and 1.3 ng/mL/year for vPSA was obtained. 35 patients left the program, with a higher percentage of patients leaving with a PSAdt less than 36 months (73.7 vs. 31.1%) and a vPSA greater than 2 ng/mL/year (68.2 vs. 31.3%). The probability of permanence and the time of permanence in AS were statistically significantly higher for those patients with favorable kinetic parameters.

Conclusion: PSA kinetics is a parameter to take into account when making decisions to keep patients in an AS program.

Keywords: Active surveillance; Low-risk prostate cancer; Prostate cancer; Prostate-specific antigen kinetics.

Publication types

  • Review

MeSH terms

  • Humans
  • Kinetics
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Observational Studies as Topic
  • Prostate-Specific Antigen* / metabolism
  • Prostatic Neoplasms* / diagnosis
  • Retrospective Studies
  • Watchful Waiting

Substances

  • Prostate-Specific Antigen