PSA doubling time versus PSA velocity to predict high-risk prostate cancer: data from the Baltimore Longitudinal Study of Aging.
BACKGROUND
Our group has previously shown that prostate-specific antigen (PSA) velocity (PSAV) is associated with the presence of life-threatening prostate cancer. Less is known about the relative utility of pretreatment PSA doubling time (PSA DT) to predict tumor aggressiveness.


OBJECTIVE
To compare the utility of PSAV and PSA DT for the prediction of life-threatening prostate cancer.


METHODS
From the Baltimore Longitudinal Study of Aging, we identified 681 men with serial PSA measurements.


METHODS
Receiver operating characteristic analysis was used to evaluate the relationship between PSAV, PSA DT, and the presence of high-risk disease.


CONCLUSIONS
Within the period of 5 yr prior to diagnosis, PSAV was significantly higher among men with high-risk or fatal prostate cancer than men without it. By contrast, PSA DT was not significantly associated with high-risk or fatal disease. On multivariate analysis, including age, date of diagnosis, and PSA, the addition of PSAV significantly improved the concordance index from 0.85 to 0.88 (p<0.001), whereas PSA DT did not.


CONCLUSIONS
These data suggest that PSAV is more useful than PSA DT in the pretreatment setting to help identify those men with life-threatening disease.
Loeb
Stacy
S
Department of Urology, The Johns Hopkins University School of Medicine, The James Buchanan Brady Urological Institute, The Johns Hopkins Hospital, Baltimore, Maryland 21287, USA. stacyloeb@gmail.com
Kettermann
Anna
A
Ferrucci
Luigi
L
Landis
Patricia
P
Metter
E Jeffrey
EJ
Carter
H Ballentine
HB
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015142:Baltimore / Q000453:epidemiology; D014408:Biomarkers, Tumor / Q000097:blood; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D012372:ROC Curve; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013997:Time Factors
D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen