Prostate-Specific Antigen Velocity Usefulness Examined

Study finds lower prostate-specific antigen velocity likely linked to insignificant disease
By Eric Metcalf
HealthDay Reporter

WEDNESDAY, Dec. 30 (HealthDay News) -- Prostate-specific antigen velocity (PSAV) may be useful in identifying men with clinically significant prostate cancer, according to research published in the January issue of The Journal of Urology.

Stacy Loeb, M.D., of the Johns Hopkins School of Medicine in Baltimore, and colleagues analyzed data from 1,073 men who underwent radical prostatectomy from 1992 to 2008.

The researchers found that men with preoperative PSAV greater than 0.4 ng/mL per year were more likely to have positive surgical margins (19 versus 12 percent), seminal vesicle invasion (4 versus 1 percent), higher tumor volume, and a Gleason score of 7 or greater. Men with preoperative PSAV below 0.4 ng/mL per year were more likely to have insignificant disease (10 versus 5 percent), defined with criteria including disease confined to the organ, a tumor volume of 0.5 cubic centimeters or less, and no Gleason pattern 4 or 5.

"Some would argue that there is no need to look at PSA history since that information is available from a single PSA measurement. Given the current study and prior series showing the associations between PSAV and important patient outcomes, most urologists would be appropriately unwilling to ignore a rapid PSA increase regardless of absolute PSA," writes the author of an accompanying editorial.

A co-author reported a financial relationship with Beckman Coulter.

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