Journal Details
First Published
14 Sep 2008
Publication timeframe
6 times per year
access type Open Access

Prostate Specific Antigen Dynamics and Features in Prostate Cancer

Published Online: 30 Aug 2021
Page range: -
Received: 07 Jun 2021
Accepted: 14 Jul 2021
Journal Details
First Published
14 Sep 2008
Publication timeframe
6 times per year

Despite the common use of the prostate-specific antigen (PSA) serum level as a tumour marker in diagnosis of prostate cancer, it seems that the PSA doubling time (PSADT) and PSA velocity (PSAV) could be more useful indicators of tumour behaviour and prognosis for patients. The aim of the study was to evaluate the value of PSAV and PSADT in the diagnosis of prostate cancer and their relationship with prostate cancer histopathological characteristics. Eighty-six patients undergoing radical prostatectomy were enrolled in the study. Based on the PSA measurements the PSA dynamic values were calculated: PSADT and PSAV. In addition, clinical and histo-pathological characteristics, including disease stage and prognostic groups were evaluated. The obtained results showed that the first PSA value was 4.29 ng/ml (1.28–13.56), the second PSA value was 7.76 ng/ml (7.60–47.60), and the third PSA value was 9.67 ng/ml (2.56–98.50). The median PSADT was 51.01 months (7.80–311.81) and the median PSAV was 2.66 ng/ml/per year (0.22–4.66). In addition, significant correlations between PSAV and pre- and post-operative Gleason score, and prognostic groups were observed. Significant correlation between PSADT and pre- and pos-toperative Gleason score and prognostic risk groups was demonstrated. This study demonstrated that PSAV and PSADT were significantly correlated with postoperative Gleason score and prognostic risk groups, demonstrating its role in the diagnosis of prostate cancer progression.


Arlen, P. M., Bianco, F., Dahut, W. L. (2008). Specific Antigen Working Group guidelines on prostate specific antigen doubling time. J. Urol., 179 (6), 2181–2185; discussion 2185–2186.Search in Google Scholar

Bartsch, G., Horninger, W., Klocker, H. (2001). Prostate cancer mortality after introduction of prostate specific antigen mass screening in the Federal State of Tyrol, Austria. Urology, 58 (3), 417–424.Search in Google Scholar

Billis, A., Guimaraes, M. S., Freitas, L. L. (2008). The impact of the 2005 International Society of Urological Pathology consensus conference on standard Gleason grading of prostatic carcinoma in needle biop-sies. J. Urol.,180 (2), 548–5452; discussion 552–553.Search in Google Scholar

Carter, H. B., Pearson, J. D., Metter, E. J. (1992). Longitudinal evaluation of prostate-specific antigen levels in men with and without prostate disease. JAMA, 267 (16), 2215–2220.Search in Google Scholar

Choo, R., Klotz, L., Deboer, G., Danjoux, C., Morton, G. (2004). Wide variation of prostate-specific antigen doubling time of untreated, clinically localized, low-to-intermediate grade, prostate carcinoma. Brit. J. Urol. Int.,94 (3), 295–298.Search in Google Scholar

D’Amico, A. V., Hanks, G. E. (1993). Linear regressive analysis using prostate-specific antigen doubling time for predicting tumor biology and clinical outcome in prostate cancer. Cancer,72 (9), 2638–2643.Search in Google Scholar

D’Amico, A. V., Chen, M. H., Roehl, K. A., Catalona, W. J. (2004). Preoperative PSA velocity and the risk of death from prostate cancer after radical prostatectomy. New Engl. J. Med.,351 (2), 125–135.Search in Google Scholar

Eggener, S. E., Yossepowitch, O., Roehl, K. A. (2008). Relationship of prostate-specific antigen velocity to histologic findings in a prostate cancer screening program. Urology, 71 (6), 1016–1019.Search in Google Scholar

Epstein, J. I., Allsbrook, W. C. J., Amin, M. B. (2005). ISUP grading committee. The 2005 International Society of Urologic Pathology (ISUP) Consensus Conference on Gleason grading of Prostatic Carcino-ma. Amer. J. Surg. Pathol.,29 (9), 1228–1242.Search in Google Scholar

Folkmanis, K., Eglitis, J., Jakubovskis, M., Lietuvietis, V., Folkmane, I, Isajevs, S. CD63 and DNA mismatch repair protein expression in prostate cancer. Proc. Latvian Acad. Sci., Section B,75 (3), 180–185.Search in Google Scholar

Heidenreich, A. (2008). Identification of high-risk prostate cancer: Role of prostate-specific antigen, PSA doubling time, and PSA velocity. Eur. Urol., 54 (5), 976–977; discussion 978–979.Search in Google Scholar

Ilic, D., O’Connor, D., Green, S. (2007). Screening for prostate cancer: A Cochrane systematic review. Cancer Causes Control.,18 (3), 279–285.Search in Google Scholar

Khatami, A., Aus, G., Damber, J. E., Lilja, H., Lodding, P., Hugosson, J. (2007). PSA doubling time predicts the outcome after active surveillance in screening-detected prostate cancer: Results from the European randomized study of screening for prostate cancer, Sweden section. Int. J. Cancer, 120 (1), 170–174.Search in Google Scholar

Loeb, S., Kettermann, A., Ferrucci, L., Landis, P., Metter, E. J., Carter, H. B. (2008). PSA doubling time versus PSA velocity to predict high-risk prostate cancer: Data from the Baltimore Longitudinal Study of Aging. Eur. Urol.,54 (5), 1073–1080.Search in Google Scholar

Loeb, S., Metter, E. J., Kac, D. (2012). Prostate-specific antigen velocity (PSAV) risk count improves the specificity of screening for clinically significant prostate cancer. Brit. J. Urol. Int.,109 (4), 508–513.Search in Google Scholar

Loeb, S., Roehl, K. A., Helfand, B. T. (2010). Can prostate specific antigen velocity decrease insignificant prostate cancer detection? J. Urol.,183 (1), 112–116.Search in Google Scholar

Lorente, J. A., Morote, J., Raventos, C. (1996). Clinical efficacy of bone alkaline phosphatase and prostate specific antigen in the diagnosis of bone metastasis in prostate cancer. J. Urol.,155 (4), 1348–1351.Search in Google Scholar

Lu-Yao, G., Albertsen, P. C., Stamford, J. L. (2002). Natural experiment examining impact of aggressive screening and treatment on prostate cancer mortality in two fixed cohorts from Seattle area and Con-necticut. Brit. Med. J., 325 (7367), 740.Search in Google Scholar

McLaren, D. B., McKenzie, M., Duncan, G., Pickles, T. (1998). Watchful waiting or watchful progression? Prostate specific antigen doubling times and clinical behavior in patients with early untreated prostate carcinoma. Cancer, 82 (2), 342–348.Search in Google Scholar

Mottet, N., Cornford, P., van den Bergh, R. C. N., De Santis, M., Fanti, S., Gillessen, S., Grummet, J., Henry, A.M., Lam, T. B., Mason, M. D., van der Kwast, T. H. et al. (2020). Oncology Guidelines, Prostate Cancer.https://uroweb.org/guideline/prostate-cancer/ (accessed 14.07.2021).Search in Google Scholar

Moul, J. W., Wu, H., Sun, L. (2004). Early versus delayed hormonal therapy for prostate specific antigen only recurrence of prostate cancer after radical prostatectomy. J. Urol.,171 (3), 1141–1147.Search in Google Scholar

O’Brien, M. F., Cronin, A. M., Fearn, P. A. (2009). Pretreatment prostate-specific antigen (PSA) velocity and doubling time are associated with outcome but neither improves prediction of outcome beyond pre-treatment PSA alone in patients treated with radical prostatectomy. J. Clin. Oncol., 27 (22), 3591–3597.Search in Google Scholar

Oudard, S., Banu, E., Scotte, F. (2007). Prostate-specific antigen doubling time before onset of chemotherapy as a predictor of survival for hormone-refractory prostate cancer patients. Ann. Oncol.,18 (11), 1828–1833.Search in Google Scholar

Post, P. N., Kil, P.J., Coebergh, J. W. (1999). Trends in survival of prostate cancer in southeastern Netherlands 1971-1989. Int. J. Cancer, 81 (4), 551–554.Search in Google Scholar

Pound, C. R., Partin, A. W., Eisenberger, M. A., Chan, D. W., Pearson, J. D., Walsh, P. C. (1999). Natural history of progression after PSA elevation following radical prostatectomy. JAMA, 281 (17), 1591–1597.Search in Google Scholar

Pruthi, R. S., Johnstone, I., Tu, I. P., Stamey, T. A. (1997). Prostate-specific antigen doubling times in patients who have failed radical prostatectomy: correlation with histologic characteristics of the primary cancer. Urology, 49 (5), 737–742.Search in Google Scholar

Raaijmakers, R., Wildhagen, M. F., Ito, K. (2004). Prostate-specific antigen change in the European Randomized Study of Screening for Prostate Cancer, section Rotterdam. Urology, 63 (2), 316–320.Search in Google Scholar

Ramirez, M. L., Nelson, E. C., Devere White, R. W. (2008). Current applications for prostate-specific antigen doubling time. Eur. Urol.,54 (2), 291–300.Search in Google Scholar

Rana, A., Karamanis, K., Lucas, M. G. (1992). Identification of metastatic disease by T category, Gleason score and serum PSA level in patients with carcinoma of the prostate. Brit. J. Urol.,69 (3), 277–281.Search in Google Scholar

Ross, P. L., Mahmud, S., Stephenson, A. J., Souhami, L., Tanguay, S., Aprikian, A. G. (2004). Variations in PSA doubling time in patients with prostate cancer on “watchful waiting”: value of short-term PSADT determinations. Urology, 64 (2), 323–328.Search in Google Scholar

Schmid, H. P., McNeal, J. E., Stamey, T. A. (1993). Observations on the doubling time of prostate cancer. The use of serial prostate-specific antigen in patients with untreated disease as a measure of increasing cancer volume. Cancer, 71 (6), 2031–2040.Search in Google Scholar

Schröder, F. H., Hugosson, J., Roobol, M. J. (2009). ERSPC Investigators. Screening and prostate-cancer mortality in a randomized European study. New Engl. J. Med.,360 (13), 1320.Search in Google Scholar

Sengupta, S., Blute, M. L., Bagniewski, S. M. (2006). Increasing prostate specific antigen following radical prostatectomy and adjuvant hormonal therapy: Doubling time predicts survival. J. Urol.,175 (5),1684–1690.Search in Google Scholar

Spurgeon, S. E., Mongoue-Tchokote, S., Collins, L. (2007). Assessment of prostate-specific antigen doubling time in prediction of prostate cancer on needle biopsy. Urology,69 (5), 931–935.Search in Google Scholar

Stephenson, A. J., Aprikian, A. G., Souhami, L., Behlouli, H., Jacobson, A. I., Bégin, L. R., Tanguay, S. (2002). Utility of PSA doubling time in follow-up of untreated patients with localized prostate cancer. Urology, 59 (5), 652–656.Search in Google Scholar

Stewart, A. J., Scher, H. I., Chen, M. H. (2005). Prostate-specific antigen nadir and cancer-specific mortality following hormonal therapy for prostate-specific antigen failure. J. Clin. Oncol.,23 (27), 6556–6560.Search in Google Scholar

Thompson, I. M., Pauler, D. K., Goodman, P. J. (2004). Prevalence of prostate cancer among men with a prostate-specific antigen level < or =4.0 ng per milliliter. New Engl. J. Med., 350 (22), 2239–2246.Search in Google Scholar

Vickers, A. J., Savage, C., O’Brien, M. F. (2009). Systematic review of pre-treatment prostate-specific antigen velocity and doubling time as predictors for prostate cancer. J. Clin. Oncol., 27 (3), 398–403.Search in Google Scholar

Recommended articles from Trend MD

Plan your remote conference with Sciendo