PSADT Unreliable For Predicting Prostate Cancer Worsening

MILAN—PSA doubling time (PSADT) is not a reliable predictor of disease progression in men with low-risk prostate cancer who are on active surveillance (AS), according to a new study presented at the 28th annual congress of the European Association of Urology.

In a study of 258 PCa patients on AS, Frederick B. Thomsen, MD, and colleagues at the University of Copenhagen in Denmark found that the 95% confidence limits for PSADT overlapped considered between three risk groups. For patients classified as high-risk (PSADT less than three years), the upper limit of the 95% CI reached into the intermediate- and low-risk range in 73% and 43% of the cases, respectively.

However, 73% of the patients classified as intermediate risk (PSADT of at least three and up to five years) had their lower limit reaching into the high-risk definition. For the 157 patients classified as low risk, the lower limit of the 95% CI reached the intermediate- and high-risk level of PSADT for 41% and 14%, respectively.

After a median of 1.2 year, 68 (26%) of 258 subjects underwent radical prostatectomy after meeting progression criteria. Histopathologic outcome was poor in 22%, intermediate in 47%, good in 31%. The researchers found no association between PSADT during AS and outcome.

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