Abstract
Objective To examine the incidence, timing, and magnitude of the prostate-specific antigen (PSA) level 'bounce' after permanent prostate brachytherapy (BT) and correlate the PSA bounce with clinical and dosimetric factors in Japanese patients with prostate cancer. Patients and methods A multi-institutional pooled analysis was carried out in 388 consecutive patients with T1-T2N0M0 prostate cancer treated with 125I-seed implant BT with no hormonal therapy or external beam radiotherapy. All patients had ≥1 year of follow-up and at least three follow-up PSA level measurements. Three definitions of PSA bounce were used: definition A, a PSA level rise of 0.1 ng/mL; definition B, a PSA level rise of 0.4 ng/mL; and definition C, a PSA level rise of 35% over the previous value, followed by a subsequent fall. RESULTS The actuarial likelihood of having PSA bounce at 24 months was 50.8% for definition A, 23.5% for definition B, and 19.4% for definition C. The median time to develop PSA bounce was 12 months for definition A, 18 months for definition B, and 18 months for definition C. There was a PSA bounce magnitude of 2 ng/mL in 5.3% of patients, and 95.3% of PSA bounce occurred within 24 months after 125I-BT. Among the before and after 125I-BT factors, clinical stage, initial PSA level, and Gleason score did not predict for PSA bounce using any definition; only being younger predicted for PSA bounce on multivariate analysis (P <0.001). CONCLUSIONS PSA bounce is a common phenomenon after 125I-BT and occurred at a rate of 19-51% in the Japanese men who underwent 125I-BT, depending on the definition used. It is more common in younger patients, and early PSA bounce should be considered when assessing a patient with a rising PSA level after 125I-BT, before implementing salvage interventions. Furthermore, PSA bounce magnitude might be lower in Japanese than in Caucasian patients.
| Original language | English |
|---|---|
| Pages (from-to) | 1064-1068 |
| Number of pages | 5 |
| Journal | BJU International |
| Volume | 103 |
| Issue number | 8 |
| DOIs | |
| Publication status | Published - Apr 2009 |
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Keywords
- Brachytherapy
- Prostate cancer
- Prostate-specific antigen (PSA) bounce
ASJC Scopus subject areas
- Urology
Cite this
Prostate-specific antigen 'bounce' after permanent 125I-implant brachytherapy in Japanese men : A multi-institutional pooled analysis. / Satoh, Takefumi; Ishiyama, Hiromichi; Matsumoto, Kazumasa; Tsumura, Hideyasu; Kitano, Masashi; Hayakawa, Kazushige; Ebara, Shin; Nasu, Yasutomo; Kumon, Hiromi; Kanazawa, Susumu; Miki, Kenta; Egawa, Shin; Aoki, Manabu; Toya, Kazuhito; Yorozu, Atsushi; Nagata, Hirohiko; Saito, Shiro; Baba, Shiro.
In: BJU International, Vol. 103, No. 8, 04.2009, p. 1064-1068.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Prostate-specific antigen 'bounce' after permanent 125I-implant brachytherapy in Japanese men
T2 - A multi-institutional pooled analysis
AU - Satoh, Takefumi
AU - Ishiyama, Hiromichi
AU - Matsumoto, Kazumasa
AU - Tsumura, Hideyasu
AU - Kitano, Masashi
AU - Hayakawa, Kazushige
AU - Ebara, Shin
AU - Nasu, Yasutomo
AU - Kumon, Hiromi
AU - Kanazawa, Susumu
AU - Miki, Kenta
AU - Egawa, Shin
AU - Aoki, Manabu
AU - Toya, Kazuhito
AU - Yorozu, Atsushi
AU - Nagata, Hirohiko
AU - Saito, Shiro
AU - Baba, Shiro
PY - 2009/4
Y1 - 2009/4
N2 - Objective To examine the incidence, timing, and magnitude of the prostate-specific antigen (PSA) level 'bounce' after permanent prostate brachytherapy (BT) and correlate the PSA bounce with clinical and dosimetric factors in Japanese patients with prostate cancer. Patients and methods A multi-institutional pooled analysis was carried out in 388 consecutive patients with T1-T2N0M0 prostate cancer treated with 125I-seed implant BT with no hormonal therapy or external beam radiotherapy. All patients had ≥1 year of follow-up and at least three follow-up PSA level measurements. Three definitions of PSA bounce were used: definition A, a PSA level rise of 0.1 ng/mL; definition B, a PSA level rise of 0.4 ng/mL; and definition C, a PSA level rise of 35% over the previous value, followed by a subsequent fall. RESULTS The actuarial likelihood of having PSA bounce at 24 months was 50.8% for definition A, 23.5% for definition B, and 19.4% for definition C. The median time to develop PSA bounce was 12 months for definition A, 18 months for definition B, and 18 months for definition C. There was a PSA bounce magnitude of 2 ng/mL in 5.3% of patients, and 95.3% of PSA bounce occurred within 24 months after 125I-BT. Among the before and after 125I-BT factors, clinical stage, initial PSA level, and Gleason score did not predict for PSA bounce using any definition; only being younger predicted for PSA bounce on multivariate analysis (P <0.001). CONCLUSIONS PSA bounce is a common phenomenon after 125I-BT and occurred at a rate of 19-51% in the Japanese men who underwent 125I-BT, depending on the definition used. It is more common in younger patients, and early PSA bounce should be considered when assessing a patient with a rising PSA level after 125I-BT, before implementing salvage interventions. Furthermore, PSA bounce magnitude might be lower in Japanese than in Caucasian patients.
AB - Objective To examine the incidence, timing, and magnitude of the prostate-specific antigen (PSA) level 'bounce' after permanent prostate brachytherapy (BT) and correlate the PSA bounce with clinical and dosimetric factors in Japanese patients with prostate cancer. Patients and methods A multi-institutional pooled analysis was carried out in 388 consecutive patients with T1-T2N0M0 prostate cancer treated with 125I-seed implant BT with no hormonal therapy or external beam radiotherapy. All patients had ≥1 year of follow-up and at least three follow-up PSA level measurements. Three definitions of PSA bounce were used: definition A, a PSA level rise of 0.1 ng/mL; definition B, a PSA level rise of 0.4 ng/mL; and definition C, a PSA level rise of 35% over the previous value, followed by a subsequent fall. RESULTS The actuarial likelihood of having PSA bounce at 24 months was 50.8% for definition A, 23.5% for definition B, and 19.4% for definition C. The median time to develop PSA bounce was 12 months for definition A, 18 months for definition B, and 18 months for definition C. There was a PSA bounce magnitude of 2 ng/mL in 5.3% of patients, and 95.3% of PSA bounce occurred within 24 months after 125I-BT. Among the before and after 125I-BT factors, clinical stage, initial PSA level, and Gleason score did not predict for PSA bounce using any definition; only being younger predicted for PSA bounce on multivariate analysis (P <0.001). CONCLUSIONS PSA bounce is a common phenomenon after 125I-BT and occurred at a rate of 19-51% in the Japanese men who underwent 125I-BT, depending on the definition used. It is more common in younger patients, and early PSA bounce should be considered when assessing a patient with a rising PSA level after 125I-BT, before implementing salvage interventions. Furthermore, PSA bounce magnitude might be lower in Japanese than in Caucasian patients.
KW - Brachytherapy
KW - Prostate cancer
KW - Prostate-specific antigen (PSA) bounce
UR - http://www.scopus.com/inward/record.url?scp=63449113150&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=63449113150&partnerID=8YFLogxK
U2 - 10.1111/j.1464-410X.2008.08234.x
DO - 10.1111/j.1464-410X.2008.08234.x
M3 - Article
C2 - 19040526
AN - SCOPUS:63449113150
VL - 103
SP - 1064
EP - 1068
JO - BJU International
JF - BJU International
SN - 1464-4096
IS - 8
ER -