Prostate-specific antigen 'bounce' after permanent 125I-implant brachytherapy in Japanese men

A multi-institutional pooled analysis

Takefumi Satoh, Hiromichi Ishiyama, Kazumasa Matsumoto, Hideyasu Tsumura, Masashi Kitano, Kazushige Hayakawa, Shin Ebara, Yasutomo Nasu, Hiromi Kumon, Susumu Kanazawa, Kenta Miki, Shin Egawa, Manabu Aoki, Kazuhito Toya, Atsushi Yorozu, Hirohiko Nagata, Shiro Saito, Shiro Baba

Research output: Contribution to journalArticle

24 Citations (Scopus)

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 languageEnglish
Pages (from-to)1064-1068
Number of pages5
JournalBJU International
Volume103
Issue number8
DOIs
Publication statusPublished - Apr 2009

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Brachytherapy
Prostate-Specific Antigen
Prostatic Neoplasms
Neoplasm Grading

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 journalArticle

Satoh, T, Ishiyama, H, Matsumoto, K, Tsumura, H, Kitano, M, Hayakawa, K, Ebara, S, Nasu, Y, Kumon, H, Kanazawa, S, Miki, K, Egawa, S, Aoki, M, Toya, K, Yorozu, A, Nagata, H, Saito, S & Baba, S 2009, 'Prostate-specific antigen 'bounce' after permanent 125I-implant brachytherapy in Japanese men: A multi-institutional pooled analysis', BJU International, vol. 103, no. 8, pp. 1064-1068. https://doi.org/10.1111/j.1464-410X.2008.08234.x
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. / Prostate-specific antigen 'bounce' after permanent 125I-implant brachytherapy in Japanese men : A multi-institutional pooled analysis. In: BJU International. 2009 ; Vol. 103, No. 8. pp. 1064-1068.
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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.",
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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

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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

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