“In our study, PSA levels measured before prostate removal surgery were significantly associated with the risk of recurrent cancer after surgery,” says Stephen Freedland, M.D., clinical instructor of urology. “These data support the notion that PSA remains the best available prostate cancer tumour marker.”
For the study, Freedland and colleagues reviewed patient records for 2,312 men who had prostate removal surgery at Hopkins between 1992 and 2004. All operations were performed by Patrick C. Walsh, M.D., professor and former chair of urology. The research team compared the association between preoperative PSA and the risk of cancer recurrence after surgery.
During an average followup of five years, 10 percent had signs of recurrent cancer. Higher PSA levels prior to surgery were significantly associated with increased risk of cancer after surgery. Compared to men with PSA levels less than 10 nanograms per milliliter, men with PSA values between 10 and 19.9 nanograms per milliliter were more than three times more likely to develop cancer after surgery. Men with PSA levels of 20 nanograms per milliliter or greater were more than five times more likely to develop cancer after surgery than those with low PSA levels.
Even in men with PSA values of less than 10 nanograms per milliliter, increasing PSA was significantly associated with increased risk of cancer after surgery. For each two-point increase in PSA, the risk of cancer after surgery approximately doubled.
“From our study and others, it is clear that a single PSA value is an extremely useful measure of a patient’s risk of progression after surgery,” Freedland says. “However, looking at how quickly the PSA increases over time is likely to be even more informative than a single value.”
MEDICA.de; Source: Johns Hopkins Medical Institutions