PSA Fails to Predict Risk in 'Watchful Waiting' Patients

Prostate-specific antigen value and rate of PSA change don't distinguish men who are at low or high risk

FRIDAY, April 6 (HealthDay News) -- In prostate cancer patients who are managed with watchful waiting, baseline prostate-specific antigen (PSA) value and the rate of PSA change do not adequately predict the development of lethal disease, according to study findings published in the April 4 issue of the Journal of the National Cancer Institute.

Katja Fall, M.D., Ph.D., of the Karolinska Institute in Stockholm, Sweden, and colleagues studied 267 Scandinavian prostate cancer patients. During a mean follow-up of 8.5 years, 34 (13 percent) of the patients died from prostate cancer and 18 (7 percent) developed metastastic disease.

Using a log-linear model, the researchers found that both PSA value at baseline and the rate of PSA change were associated with the development of lethal prostate cancer. Using a receiver operating characteristic analysis, however, they found that PSA value at baseline and the rate of PSA change were poor predictors of either indolent or progressive disease.

"These data demand that clinical trials commence now to examine surveillance strategies to help patients and their physicians identify and treat tumors that will otherwise be life threatening and to carefully follow those that will not," state the authors of an accompanying editorial. "Our limited health care resources and the quality of life of an enormous number of men will benefit from this for decades to come."

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