Author/Authors :
Nowroozi، Mohammad-Reza نويسنده , , Zeighami، Shahryar نويسنده Division of Uro-oncology, Department of Urology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran , , Ayati، Mohsen نويسنده , , Jamshidian، Hassan نويسنده , , Ranjbaran، Ali Reza نويسنده Division of Uro-oncology, Department of Urology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran , , Moradi، Asaad نويسنده Fertility-Infertility Research Center, Urology and Nephrology Research Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermansh , , Afsar ، Firuzeh نويسنده Division of Uro-oncology, Department of Urology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran ,
Abstract :
Introduction: Our aim was to evaluate the value of serum prostate-specific antigen doubling time (PSADT) to differentiate patients with high-grade prostate cancer who require more aggressive therapy from those with low-grade cancer. Materials and Methods: Of 460 patients with extended 12-core transrectal ultrasonography-guided biopsy of the prostate, 59 with confirmed prostate cancer were selected. They had not received any previous treatment for prostate cancer and had at least 2 consecutive serum PSA tests with a rising trend. The PSADT was calculated in patients with 2 serum PSA levels measured with an interval more than 3 months. Results: Of 59 patients with prostate cancer, 35 (59.3%) had low-grade and 24 (40.7%) had high-grade tumors. There was no difference in age between the two groups. The median PSADT in patients with high-grade and low-grade tumors were 12.70 months (range, 0.7 to 44.8 months) and 25.00 months (range, 1.65 to 41.2 months; P = .001). A total of 21 patients with high-grade tumors (87.5%) had a PSADT less than 12 months, while only 9 of those with low-grade tumors (25.7%) had a PSADT less than 12 months. A PSADT cutoff of 12 months provided a sensitivity of 74% and a specificity of 87% for differentiation of high-grade from low-grade cancers. Conclusion: We concluded that men with a short PSADT ( < 12 months) were at a higher risk of harboring a high-grade prostate cancer. Our data suggests PSADT can identify patients with high-grade tumors who require more aggressive therapy.
