PSA velocity in conservatively managed BPH: can it predict the need for BPH-related invasive therapy?
OBJECTIVE
To study the value of PSA velocity (PSAV) to predict benign prostatic hyperplasia (BPH) progression in patients managed with alpha(1)-blockers or watchful waiting (WW).


METHODS
Nine hundred and forty two BPH patients treated with alpha(1)-blocker or WW were reviewed. PSAV was defined as: (PSA(t)-PSA(b))/(t/12); where PSA(t) = PSA at time of follow-up (t, in months), PSA(b) = PSA at baseline. PSA(t) was taken from the 1 year follow-up visit or, if not present, from the next available visit with a maximum of 24 months.


RESULTS
Five hundred and ninety five patients (234 alpha(1)-blocker, 361 WW) were included in the analyses. PSAV range was -5.24 to 43.06 ng/ml/year in alpha(1)-blocker patients and -6.11 to 19.55 ng/ml/year in WW patients (median: 0.01 ng/ml/year). PSAV was stratified into tertiles (Stable/Decrease/Increase). There were no significant differences in retreatment-free survival and the risk of BPH-related invasive therapy between the tertiles in both treatment groups.


CONCLUSIONS
PSAV did not predict BPH progression in either alpha(1)-blocker treated patients or WW group.
Mochtar
Chaidir A
CA
Department of Urology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. C.A.Mochtar@amc.uva.nl
Kiemeney
Lambertus A L M
LA
Laguna
M Pilar
MP
Debruyne
Frans M J
FM
de la Rosette
Jean J M C H
JJ
D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D000368:Aged; D018450:Disease Progression; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood*; D011470:Prostatic Hyperplasia / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy*; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome
D000317:Adrenergic alpha-Antagonists; D017430:Prostate-Specific Antigen