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. 2011:5:101-6.
doi: 10.4137/CMO.S7073. Epub 2011 Apr 19.

Rapid Increase of the Serum PSA Level in Response to High-Intensity Focused Ultrasound Therapy may be a Potential Indicator of Biochemical Recurrence of Low- and Intermediate-Risk Prostate Cancer

Teruo Inamoto  1 , Kazumasa Komura, Toshikazu Watsuji, Haruhito Azuma
Affiliations

Rapid Increase of the Serum PSA Level in Response to High-Intensity Focused Ultrasound Therapy may be a Potential Indicator of Biochemical Recurrence of Low- and Intermediate-Risk Prostate Cancer

Teruo Inamoto et al. Clin Med Insights Oncol. 2011.

Abstract

Objectives: To determine the incidence and magnitude of the rapid increase in the serum PSA (riPSA) level after high-intensity focused ultrasound (HIFU) therapy for prostate cancer, and its correlation with clinical factors.

Methods: A total of 176 patients with localized prostate cancer underwent HIFU therapy. Serum riPSA was determined on the basis of the same criteria as those for "PSA bounce", ie, an increase of ≥0.2 ng/ml with a spontaneous return to the prebounce level or lower. Patients were stratified according to neoadjuvant PSA level, T stage, risk group, age, Gleason score, pretreatment PSA level, post-treatment PSA nadir, and number of HIFU sessions.

Results: riPSA was seen in 53% of patients during a median follow-up period of 43 months. A PSA nadir was achieved within 3 months for 85.1% of the treatments. In all cases, onset of riPSA was seen two days after HIFU therapy, and the median magnitude was 23.69 ng/ml. A magnitude of >2 ng/ml was seen in 89.4% of cases. Univariate analysis revealed that patients with riPSA were associated with usage of hormonal therapy and the post-treatment PSA nadir level. Multivariate Cox regression analysis revealed that riPSA and the number of HIFU sessions were predictors of biochemical recurrence. A significant statistical association was found between the presence of riPSA and the risk of biochemical failure only in the low- and intermediate-risk group.

Conclusion: Patients treated with HIFU who experience post-treatment riPSA may have an increased risk of biochemical recurrence, especially in non-high-risk patients.

Keywords: HIFU; PSA; prostate cancer.

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Figures

Figure 1
Figure 1
Biochemical recurrence-free survival curve for all patients who underwent HIFU treatment. riPSA = rapid increase of the PSA level.
Figure 2
Figure 2
Biochemical recurrence-free survival curve for the patients who underwent HIFU treatment. riPSA = rapid increase of the PSA level. A) Biochemical recurrence-free survival curve for the D’Amico high-risk group. B) Biochemical recurrence-free survival curve for the D’Amico low- and intermediate-risk group.
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References

    1. Rosser CJ, Kamat AM, Wang X, et al. Is patient age a factor in the occurrence of prostate-specific antigen bounce phenomenon after external beam radiotherapy for prostate cancer? Urology. 2005;66:327–31. - PubMed
    1. Pickles T. Prostate-specific antigen (PSA) bounce and other fluctuations: which biochemical relapse definition is least prone to PSA false calls? An analysis of 2030 men treated for prostate cancer with external beam or brachytherapy with or without adjuvant androgen deprivation therapy. Int J Radiat Oncol Biol Phys. 2006;64:1355–9. - PubMed
    1. Mitchell DM, Swindell R, Elliott T, et al. Analysis of prostate-specific antigen bounce after I(125) permanent seed implant for localised prostate cancer. Radiother Oncol. 2008;88:102–7. - PubMed
    1. Stock RG, Stone NN, Cesaretti JA. Prostate-specific antigen bounce after prostate seed implantation for localized prostate cancer: descriptions and implications. Int J Radiat Oncol Biol Phys. 2003;56:448–53. - PubMed
    1. Crook J, Gillan C, Yeung I, et al. PSA kinetics and PSA bounce following permanent seed prostate brachytherapy. Int J Radiat Oncol Biol Phys. 2007;69:426–33. - PubMed