PMID- 26385021
OWN - NLM
STAT- MEDLINE
DCOM- 20170501
LR  - 20181113
IS  - 1464-410X (Electronic)
IS  - 1464-4096 (Print)
IS  - 1464-4096 (Linking)
VI  - 118
IP  - 4
DP  - 2016 Oct
TI  - Variation in serum prostate-specific antigen levels in men with prostate cancer 
      managed with active surveillance.
PG  - 535-40
LID - 10.1111/bju.13328 [doi]
AB  - OBJECTIVE: To describe fluctuations in prostate-specific antigen (PSA) levels in 
      men managed with active surveillance (AS) to determine if a single PSA increase 
      is a consistent measure to use to trigger intervention. PATIENTS AND METHODS: We 
      evaluated data on 541 patients undergoing AS between 1995 and 2011. PSA variation 
      was described by studying the Kaplan-Meier probability of patients' PSA levels 
      reaching 4 or 7 ng/mL, falling below those thresholds, and then rising to those 
      thresholds again. We also examined PSA variation by calculating the Kaplan-Meier 
      probability of a PSA change followed by an equal or greater change in the 
      opposite direction. RESULTS: We analysed data on 541 patients undergoing AS with 
      a median (interquartile range [IQR]) of 8 (6-12) PSA measurements and undergoing 
      AS for a median (IQR) of 4 (2-6) years. The 5-year estimate of the probability of 
      reaching a threshold PSA of 7 ng/mL was 40% (95% confidence interval [CI] 35-46%) 
      and the 5-year estimate of subsequently falling below this threshold was 90% (95% 
      CI 82-95%). The 5-year estimate of a PSA direction change was 95% (95% CI 93-97%) 
      overall and 56% (95% CI 51-61%) for PSA direction changes of >/=1 ng/mL. 
      CONCLUSIONS: We observed a high probability of variability in PSA levels for 
      patients on AS. The probability of changes in PSA, defined by an increase to the 
      specified thresholds or a rise >1 ng/mL within 6 months and subsequent decrease 
      of equal or greater value on a subsequent measurement, increases over time; 
      therefore, a single change in PSA level is not a reliable endpoint for patients 
      on AS.
CI  - (c) 2015 The Authors BJU International (c) 2015 BJU International Published by John 
      Wiley & Sons Ltd.
FAU - Ehdaie, Behfar
AU  - Ehdaie B
AD  - Urology Service, Sidney Kimmel Center for Prostate and Urologic Cancers, New 
      York, NY, USA. ehdaieb@mskcc.org.
AD  - Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer 
      Center, New York, NY, USA. ehdaieb@mskcc.org.
FAU - Poon, Bing Ying
AU  - Poon BY
AD  - Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer 
      Center, New York, NY, USA.
FAU - Sjoberg, Daniel D
AU  - Sjoberg DD
AD  - Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer 
      Center, New York, NY, USA.
FAU - Recabal, Pedro
AU  - Recabal P
AD  - Urology Service, Sidney Kimmel Center for Prostate and Urologic Cancers, New 
      York, NY, USA.
AD  - Urology Service, Fundacion Arturo Lopez Perez, Santiago, Chile.
FAU - Laudone, Vincent
AU  - Laudone V
AD  - Urology Service, Sidney Kimmel Center for Prostate and Urologic Cancers, New 
      York, NY, USA.
FAU - Touijer, Karim
AU  - Touijer K
AD  - Urology Service, Sidney Kimmel Center for Prostate and Urologic Cancers, New 
      York, NY, USA.
FAU - Eastham, James
AU  - Eastham J
AD  - Urology Service, Sidney Kimmel Center for Prostate and Urologic Cancers, New 
      York, NY, USA.
FAU - Scardino, Peter T
AU  - Scardino PT
AD  - Urology Service, Sidney Kimmel Center for Prostate and Urologic Cancers, New 
      York, NY, USA.
LA  - eng
GR  - P30 CA008748/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Observational Study
DEP - 20151026
PL  - England
TA  - BJU Int
JT  - BJU international
JID - 100886721
RN  - EC 3.4.21.77 (Prostate-Specific Antigen)
SB  - IM
MH  - Aged
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prostate-Specific Antigen/*blood
MH  - Prostatic Neoplasms/*blood/*therapy
MH  - Retrospective Studies
MH  - *Watchful Waiting
PMC - PMC5523832
MID - NIHMS863478
OTO - NOTNLM
OT  - PSA
OT  - active surveillance
OT  - prostate cancer
OT  - prostate specific antigen
EDAT- 2015/09/20 06:00
MHDA- 2017/05/02 06:00
PMCR- 2017/10/01
CRDT- 2015/09/20 06:00
PHST- 2015/09/20 06:00 [entrez]
PHST- 2015/09/20 06:00 [pubmed]
PHST- 2017/05/02 06:00 [medline]
PHST- 2017/10/01 00:00 [pmc-release]
AID - 10.1111/bju.13328 [doi]
PST - ppublish
SO  - BJU Int. 2016 Oct;118(4):535-40. doi: 10.1111/bju.13328. Epub 2015 Oct 26.