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Prognostic value of PSA bounce after definitive radiotherapy revisited

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Abstract

Background

Prostate-specific antigen (PSA) bounce after definitive radiotherapy has been reported as a predictor of improved biochemical recurrence-free survival (BCRFS). We revisited this phenomenon to confirm its clinical impact on oncological outcomes in patients with long-term follow-up who were free of biochemical recurrence (BCR) at least 3 years after treatment.

Materials and methods

A total of 541 patients with localized, intermediate-risk prostate cancer underwent low-dose rate brachytherapy with iodine-125 seeds with or without supplemental external beam radiotherapy in combination. Neoadjuvant hormonal therapy was administered to 273 patients (50.5%) with a median duration of 3 months (range 1–108 months). PSA bounce was defined as ≥ 0.2 ng/ml increase above the interval PSA nadir, followed by a decrease below that value.

Results

The median age was 69 years (range 49–90 years). The median follow-up duration was 102 months (range 36–205 months). One-hundred and fifty patients (27.7%) had PSA bounce with a median magnitude of 0.47 ng/ml (range 0.2–3.19 ng/ml). Age was significantly associated with the occurrence of PSA bounce [age: hazard ratio (HR) 0.95, 95% confidence interval (CI) 0.93–0.98]. It was found to be independently associated with a decreased risk for BCR (HR 0.29; 95% CI 0.12–0.69) and clinical progression (HR 0.44; 95% CI 0.95–0.98).

Conclusion

PSA bounce indicated a favorable BCRFS and clinical progression-free survival in patients who had been free of BCR for at least 3 years after definitive radiotherapy.

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Acknowledgements

This study was supported in part by a grant of SHIP0804 (NCT00664456).

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Authors and Affiliations

  1. Department of Urology, The Jikei University School of Medicine, Tokyo, Japan

    Fumihiko Urabe, Takahiro Kimura, Hiroshi Sasaki, Kojiro Tashiro, Kosuke Iwatani, Kenta Miki & Shin Egawa

  2. Department of Radiology, The Jikei University School of Medicine, Tokyo, Japan

    Manabu Aoki

  3. Department of Pathology, The Jikei University School of Medicine, Tokyo, Japan

    Shun Sato & Hiroyuki Takahashi

Authors
  1. Fumihiko Urabe
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  2. Takahiro Kimura
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  3. Hiroshi Sasaki
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  4. Kojiro Tashiro
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  5. Kosuke Iwatani
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  6. Manabu Aoki
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  7. Shun Sato
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  8. Hiroyuki Takahashi
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  9. Kenta Miki
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  10. Shin Egawa
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Correspondence to Fumihiko Urabe.

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Urabe, F., Kimura, T., Sasaki, H. et al. Prognostic value of PSA bounce after definitive radiotherapy revisited. Int J Clin Oncol 27, 411–417 (2022). https://doi.org/10.1007/s10147-021-02053-0

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  • DOI: https://doi.org/10.1007/s10147-021-02053-0

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