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

 Ji Eun Heo  ;  Kyo Chul Koo  ;  Sung Joon Hong  ;  Sang Un Park  ;  Byung Ha Chung  ;  Kwang Suk Lee 
 Yonsei Medical Journal, Vol.59(2) : 219-225, 2018 
Journal Title
 Yonsei Medical Journal 
Issue Date
5-alpha Reductase Inhibitors/*therapeutic use ; Aged ; *Biopsy ; Follow-Up Studies ; Humans ; Kinetics ; Male ; Middle Aged ; Neoplasm Grading ; Predictive Value of Tests ; Prostate-Specific Antigen/*blood ; Prostatic Neoplasms/blood/*drug therapy/*pathology
5alpha-reductase inhibitors ; Prostate biopsy ; prostate-specific antigen
PURPOSE: To evaluate parameters for determining repeat prostate biopsy in patients with 5alpha-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.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
구교철(Koo, Kyo Chul) ORCID logo https://orcid.org/0000-0001-7303-6256
박상언(Park, Sang Un)
이광석(Lee, Kwang Suk) ORCID logo https://orcid.org/0000-0002-7961-8393
정병하(Chung, Byung Ha) ORCID logo https://orcid.org/0000-0001-9817-3660
허지은(Heo, Ji Eun) ORCID logo https://orcid.org/0000-0002-4184-8468
홍성준(Hong, Sung Joon) ORCID logo https://orcid.org/0000-0001-9869-065X
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