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. 2018 Mar;59(2):219-225.
doi: 10.3349/ymj.2018.59.2.219.

Prostate-Specific Antigen Kinetics Following 5α-Reductase Inhibitor Treatment May Be a Useful Indicator for Repeat Prostate Biopsy

Ji Eun Heo  1 , Kyo Chul Koo  1 , Sung Joon Hong  2 , Sang Un Park  3 , Byung Ha Chung  1 , Kwang Suk Lee  4
Affiliations

Prostate-Specific Antigen Kinetics Following 5α-Reductase Inhibitor Treatment May Be a Useful Indicator for Repeat Prostate Biopsy

Ji Eun Heo et al. Yonsei Med J. 2018 Mar.

Abstract

Purpose: To evaluate parameters for determining repeat prostate biopsy in patients with 5α-reductase inhibitor (5ARI) treatment after initial negative biopsy.

Materials and methods: From January 2007 to December 2015, patients who underwent a repeat prostate biopsy after an initial negative biopsy were enrolled from multiple institutions. Serial prostate-specific antigen (PSA) levels after the initial biopsy were analyzed for PSA kinetics. Clinicopathologic variables were evaluated according to the use of 5ARIs after the initial negative biopsy.

Results: Of 419 patients with initial negative biopsies (median age=67.0 years, median PSA=6.31 ng/mL), 101 patients (24.1%) were diagnosed with prostate cancer at the repeat biopsy. An increase in PSA level at 18 months, compared to that at 6 months, was a predictor of a positive repeat biopsy. However, the use of 5ARIs was not identified as a predictor. Of 126 patients receiving 5ARI treatment after the initial biopsy, 30 (23.8%) were diagnosed with prostate cancer at the repeat biopsy. Increase in PSA level at more than two time points after 6 months of 5ARI treatment (odds ratio=4.84, p=0.005) was associated with cancer detection at the repeat biopsy. There were no significant 5ARI group-related differences in the detection rates of prostate and high-grade cancers (Gleason score ≥7).

Conclusion: The effects of 5ARIs on prostate cancer detection and chemoprevention remain uncertain. However, more than two increases in PSA level after 6 months of 5ARI treatment may indicate the presence of prostate cancer.

Keywords: 5α-reductase inhibitors; Prostate biopsy; prostate-specific antigen.

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Conflict of interest statement

The authors have no financial conflicts of interest.

Figures

Fig. 1
Fig. 1. Algorithm to recommend repeat prostate biopsy in patients undergoing 5ARI treatment. 5ARIs, 5α-reductase inhibitors; PSA, prostate-specific antigen.
See this image and copyright information in PMC

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References

    1. Schröder FH. Landmarks in prostate cancer screening. BJU Int. 2012;110(Suppl 1):3–7. - PubMed
    1. Basch E, Oliver TK, Vickers A, Thompson I, Kantoff P, Parnes H, et al. Screening for prostate cancer with prostate-specific antigen testing: American Society of Clinical Oncology Provisional Clinical Opinion. J Clin Oncol. 2012;30:3020–3025. - PMC - PubMed
    1. Presti JC, Jr, O’Dowd GJ, Miller MC, Mattu R, Veltri RW. Extended peripheral zone biopsy schemes increase cancer detection rates and minimize variance in prostate specific antigen and age related cancer rates: results of a community multi-practice study. J Urol. 2003;169:125–129. - PubMed
    1. Koo KC, Lee DH, Lee SH, Chung BH. Peripheral zone prostate-specific antigen density: an effective parameter for prostate cancer prediction in men receiving 5α-reductase inhibitors. Prostate Int. 2013;1:102–108. - PMC - PubMed
    1. Choi YH, Cho SY, Cho IR. The different reduction rate of prostate-specific antigen in dutasteride and finasteride. Korean J Urol. 2010;51:704–708. - PMC - PubMed

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