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Previous Volume 351:125-135 July 8, 2004 Number 2 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Editorial by Eisenberger, M. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

ABSTRACT

Background We evaluated whether men at risk for death from prostate cancer after radical prostatectomy can be identified using information available at diagnosis.

Methods We studied 1095 men with localized prostate cancer to assess whether the rate of rise in the prostate-specific antigen (PSA) level — the PSA velocity — during the year before diagnosis, the PSA level at diagnosis, the Gleason score, and the clinical tumor stage could predict the time to death from prostate cancer and death from any cause after radical prostatectomy.

Results As compared with an annual PSA velocity of 2.0 ng per milliliter or less, an annual PSA velocity of more than 2.0 ng per milliliter was associated with a significantly shorter time to death from prostate cancer (P<0.001) and death from any cause (P=0.01). An increasing PSA level at diagnosis (P=0.01), a Gleason score of 8, 9, or 10 (P=0.02), and a clinical tumor stage of T2 (P<0.001) also predicted the time to death from prostate cancer. For men with an annual PSA velocity of more than 2.0 ng per milliliter, estimates of the risk of death from prostate cancer and death from any cause seven years after radical prostatectomy were also influenced by the PSA level, tumor stage, and Gleason score at diagnosis.

Conclusions Men whose PSA level increases by more than 2.0 ng per milliliter during the year before the diagnosis of prostate cancer may have a relatively high risk of death from prostate cancer despite undergoing radical prostatectomy.

Source Information

From Brigham and Women's Hospital and Dana–Farber Cancer Institute, Boston (A.V.D.); the Department of Radiation Oncology, Harvard Medical School, Boston (A.V.D.); the Department of Statistics, University of Connecticut, Storrs (M.-H.C.); the Department of Psychiatry, Washington University School of Medicine, St. Louis (K.A.R.); and the Department of Urology, Northwestern Feinberg School of Medicine, Chicago (W.J.C.).

Address reprint requests to Dr. D'Amico at the Department of Radiation Oncology L-2 Level, Brigham and Women's Hospital, 75 Francis St., Boston, MA 02115, or at adamico{at}lroc.harvard.edu.

Full Text of this Article

Related Letters:

PSA Velocity and Prostate Cancer
Dodd L. E., Simon R., Bianco F. J. Jr., Kattan M. W., Scardino P. T., D'Amico A. V., Chen M.-H., Catalona W. J.
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N Engl J Med 2004; 351:1800-1802, Oct 21, 2004. Correspondence

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