title: Prebiopsy PSA velocity not reliable predictor of prostate cancer diagnosis, Gleason score, tumor location, or cancer volume after TTMB.
abstract: OBJECTIVE
  To evaluate the effect of prostate-specific antigen (PSA) velocity (PSAV) on prostate cancer diagnosis, Gleason score, tumor location, and cancer volume in men undergoing transperineal template-guided mapping biopsy (TTMB). PSAV has been associated with greater Gleason scores and greater prostate cancer-specific mortality.
  
  
  METHODS
  From January 2005 through September 2007, 217 patients underwent TTMB. The inclusion criteria included a persistently elevated PSA level and/or diagnosis of atypical small acinar proliferation or high-grade prostatic intraepithelial neoplasia on previous biopsy. The prostate gland was arbitrarily divided into 24 regions, and a median of 58 cores were obtained per patient. The patients were divided into 3 velocity cohorts according to the following changes in PSA level in the year before biopsy: < or =0.0, 0.1-1.9, and > or =2.0 ng/mL. The PSAV was evaluated as a predictor for prostate cancer diagnosis, Gleason score, tumor volume, and cancer location.
  
  
  RESULTS
  The mean patient age was 64.2 years, with a mean prebiopsy PSA level of 8.5 ng/mL. Prostate cancer was diagnosed in 97 patients (44.7%). The study population had undergone an average of 1.8 +/- 1.0 biopsies before TTMB. PSAV did not predict for prostate cancer diagnosis (P = .84), Gleason score (P = .78), the percentage of positive cores (P = .37), or tumor location.
  
  
  CONCLUSIONS
  Among patients with persistently elevated PSA levels despite previously negative biopsy findings, PSAV did not reliably predict for a diagnosis of prostate cancer nor did it correlate with prostate cancer grade, volume, or location using TTMB.
authors.affiliation: Department of Radiation Oncology, University of Washington, Seattle, Washington, USA.
authors.forename: Nathan
authors.initials: N
authors.lastname: Bittner
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Merrick
authors.forename: Hugo
authors.initials: H
authors.lastname: Andreini
authors.forename: Walter
authors.initials: W
authors.lastname: Taubenslag
authors.forename: Zachariah A
authors.initials: ZA
authors.lastname: Allen
authors.forename: Wayne M
authors.initials: WM
authors.lastname: Butler
authors.forename: Richard L
authors.initials: RL
authors.lastname: Anderson
authors.forename: Edward
authors.initials: E
authors.lastname: Adamovich
authors.forename: Kent E
authors.initials: KE
authors.lastname: Wallner
mesh_terms: D001707:Biopsy, Needle / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000175:diagnosis*
chemical_list: D017430:Prostate-Specific Antigen