title: Prostate-specific antigen doubling time as a predictor of Gleason grade in prostate cancer.
abstract: BACKGROUND
  Our aim was to evaluate the value of serum prostate-specific antigen doubling time (PSADT) to identify patients with high-grade prostate cancer who require more aggressive therapy from those with low-grade cancer.
  
  
  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.
  
  
  CONCLUSIONS
  We showed that men with a short PSADT (< 12 months) were at a higher risk of harboring a high-grade prostate cancer. Our data suggests PSADT to identify patients with high-grade tumors who require more aggressive therapy.
authors.affiliation: Division of Uro-oncology, Department of Urology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Nowroozi
authors.forename: Shahryar
authors.initials: S
authors.lastname: Zeighami
authors.forename: Mohsen
authors.initials: M
authors.lastname: Ayati
authors.forename: Hassan
authors.initials: H
authors.lastname: Jamshidian
authors.forename: Ali Reza
authors.initials: AR
authors.lastname: Ranjbaran
authors.forename: Asaad
authors.initials: A
authors.lastname: Moradi
authors.forename: Firuzeh
authors.initials: F
authors.lastname: Afsar
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D015331:Cohort Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000473:pathology* / Q000628:therapy; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D017430:Prostate-Specific Antigen