BACKGROUND: Prostate-specific antigen (PSA) is a useful biomarker for risk classification in patients with prostate cancer.
However, it is unclear whether a correlation exists between low PSA levels (< 10 ng/ml) at diagnosis and prognosis.
METHODS: Of the 642 Japanese patients who underwent prostate biopsy and were diagnosed with prostate cancer at Kanazawa University Hospital from 2000 to 2010, 406 patients with a PSA level < 20 ng/ml were retrospectively reviewed.
RESULTS: PSA levels in 275 (68%) patients were < 10 ng/ml. Although the percentage of Gleason score 8-10 in patients with a PSA level of < 3.5 ng/ml was higher than that in patients with a PSA level between 3.5 and 10 ng/ml, it was not statistically significant. On the other hand, the percentage of higher stage (T3 and T4) patients with a PSA level < 3.5 ng/ml was significantly greater than that in patients with a PSA level between 3.5 and 10 ng/ml (P < 0.0001). The percentage of metastases (N1 and M1) in patients with a PSA level < 3.5 ng/ml was also significantly higher than that in patients with a PSA level between 3.5 and 10 ng/ml (P = 0.0112).
CONCLUSIONS: Patients with prostate cancer with a PSA level < 3.5 ng/ml at diagnosis had a more advanced stage of cancer compared with those with a PSA level between 3.5 and 10 ng/ml. Therefore, risk classification using PSA levels at diagnosis may need to take into consideration this specific PSA range in order to better predict survival.
Izumi K, Ikeda H, Maolake A, Machioka K, Nohara T, Narimoto K, Ueno S, Kadono Y, Kitagawa Y, Konaka H, Mizokami A, Namiki M. Are you the author?
Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
Reference: Prostate. 2015 Mar 8. Epub ahead of print.