title: Validation of increasing prostate specific antigen as a predictor of prostate cancer death after treatment of localized prostate cancer with surgery or radiation.
abstract: OBJECTIVE
  Many patients who undergo surgery or radiation therapy to treat localized prostate cancer experience an increase in serum prostate specific antigen (PSA) after treatment. This study documents patterns of PSA recurrence after surgery or radiation to treat localized prostate cancer and quantifies the extent to which an increasing PSA predicts death from prostate cancer.
  
  
  METHODS
  Posttreatment PSA levels were measured on a population based cohort of 1136 men diagnosed with localized prostate cancer in community practice in Connecticut between 1990 and 1992, and treated within 6 months of diagnosis with surgery or radiation with or without androgen withdrawal therapy. The major outcome measure was death from prostate cancer.
  
  
  RESULTS
  PSA recurrence followed a log-linear pattern over time. Patients who died of prostate cancer had a median PSA doubling time of 0.8 years (25th and 75th percentiles 0.5 to 1.4 years). Patients who did not die of prostate cancer within 10 years of diagnosis had either no posttreatment increase in serum PSA (40%) or had a PSA doubling time longer than 1 year (44%).
  
  
  CONCLUSIONS
  Patients whose posttreatment PSA doubling times before the initiation of androgen withdrawal therapy are less than 1 year are at high risk of dying of prostate cancer within 10 years of diagnosis. Men with PSA recurrences that are doubling at rates greater than 1 year are at low risk of death from prostate cancer within 10 years of diagnosis.
authors.affiliation: University of Connecticut Health Center, Farmington, Connecticut 06030-3955, USA. Albertsen@nso.uchc.edu
authors.forename: Peter C
authors.initials: PC
authors.lastname: Albertsen
authors.forename: James A
authors.initials: JA
authors.lastname: Hanley
authors.forename: David F
authors.initials: DF
authors.lastname: Penson
authors.forename: Judith
authors.initials: J
authors.lastname: Fine
mesh_terms: D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D011237:Predictive Value of Tests; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy / Q000628:therapy*; D012189:Retrospective Studies
chemical_list: D017430:Prostate-Specific Antigen