Prostate Cancer Distant Metastasis Predicted by APV

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Highest quartile of alkaline phosphatase velocity in men who experience biochemical recurrence after radical prostatectomy is associated with 2-fold higher risk.
Highest quartile of alkaline phosphatase velocity in men who experience biochemical recurrence after radical prostatectomy is associated with 2-fold higher risk.
The following article is part of conference coverage from the 2017 American Urological Association meeting in Boston. Renal and Urology News' staff will be reporting live on medical studies conducted by urologists and other specialists who are tops in their field in kidney stones, prostate cancer, kidney cancer, bladder cancer, enlarged prostate, and more. Check back for the latest news from AUA 2017. 

BOSTON—Rapid alkaline phosphatase velocity predicts an elevated risk for distant metastases among men who experience biochemical recurrence of prostate cancer (PCa) following radical prostatectomy (RP), according to study findings presented at the American Urological Association 2017 annual meeting.

Alkaline phosphatase (AP) is a known marker for bone metastases that correlates with extent of disease burden.

The finding is based on a retrospective study of 736 patients enrolled in the Center for Prostate Disease Research multicenter national database who underwent RP and subsequently experienced biochemical recurrence (BCR), defined as a PSA level of 0.2 ng/mL or higher at 8 weeks or more following RP followed by a confirmatory PSA level of 0.2 ng/mL or higher. The investigators calculated AP velocity (APV) as the slope of the linear regression line of all alkaline phosphatase (AP) volumes after RP and prior to distant metastasis. APV values in the highest quartile (3.29 U/L/year or higher) were considered rapid. Compared with values in the 3 lower quartiles, those in the highest quartile were associated with a 2-fold higher risk of distant metastases, Carolyn Salter, MD, of the National Cancer Institute in Bethesda, Maryland, and colleagues reported in a poster presentation.

“This study demonstrated that APV may be a valuable tool for prognosticating distant metastasis in a more inclusive group of all PCa patients who experience BCR after RP,” the investigators concluded.

Visit Renal and Urology News' conference section for continuous coverage from AUA 2017.

Reference

Salter C, Cullen J, Rosner I, et al. Alkaline phosphatase velocity predicts metastasis among prostate cancer patients who experience biochemical recurrence after radical prostatectomy. [abstract] J Urol 2017;197(4S):e168-e169. Poster presented at the American Urological Association 2017 annual meeting in Boston on May 12, 2017. Poster MP14-18.

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