Introduction: This study analyzes the value of PSA kinetics, PSA speed (vPSA), and PSA doubling time (PSAdt), in patients with low-risk prostate cancer who are in an active surveillance (AS) program. Methods: An observational, retrospective, and longitudinal study of a sample of 86 patients included in AS program between January 2014 and October 2021 was conducted. A review of their medical records was performed, and PSA kinetics were calculated, analyzing the causes of discontinuation of the AS program and its relationship with PSA kinetics. Results: The mean age was 63.39 years, and the median follow-up was 62.55 months. The mean PSA at diagnosis was 8.27 ng/mL. A median of PSAdt of 62.55 months and 1.3 ng/mL/year for vPSA was obtained. 35 patients left the program, with a higher percentage of patients leaving with a PSAdt less than 36 months (73.7 vs. 31.1%) and a vPSA greater than 2 ng/mL/year (68.2 vs. 31.3%). The probability of permanence and the time of permanence in AS were statistically significantly higher for those patients with favorable kinetic parameters. Conclusion: PSA kinetics is a parameter to take into account when making decisions to keep patients in an AS program.

1.
Shill
DK
,
Roobol
MJ
,
Ehdaie
B
,
Vickers
AJ
,
Carlsson
SV
.
Active surveillance for prostate cancer
.
Transl Androl Urol
.
2021
;
10
(
6
):
2809
19
.
2.
Litwin
MS
,
Tan
HJ
.
The diagnosis and treatment of prostate cancer. A review
.
JAMA
.
2017
;
317
(
24
):
2532
42
.
3.
Celma Domènech
A
,
Planas Morin
J
,
Morote Robles
J
.
Optimización del seguimiento de cáncer de próstata en vigilancia activa
.
Arch Esp Urol
.
2014
;
67
(
5
):
442
51
.
4.
Rubio-Briones
J
,
Borque
A
,
Esteban
LM
,
Iborra
I
,
López
PA
,
Gil
JM
.
Preliminary results of the Spanish association of Urology national registry in active surveillance for prostate cancer
.
Actas Urol Esp
.
2016
;
40
(
1
):
3
10
.
5.
van den Bergh
RCN
,
Roemeling
S
,
Roobol
MJ
,
Wolters
T
,
Schröder
FH
,
Bangma
CH
.
Prostate-specific antigen kinetics in clinical decision- making during active surveillance for early prostate cancer- A review
.
Eur Urol
.
2008
;
54
(
3
):
505
16
.
6.
Thomsen
FB
,
Brasso
K
,
Berg
KD
,
Gerds
TA
,
Johansson
JE
,
Angelsen
A
.
Association between PSA kinetics and cancer-specific mortality in patients with localised prostate cancer: analysis of the placebo arm of the SPCG-6 study
.
Ann Oncol
.
2016
;
27
(
3
):
460
6
.
7.
Mottet
N
,
van den Bergh
RCN
,
Briers
E
,
Van den Broeck
T
,
Cumberbatch
MG
,
De Santis
M
.
EAU-EANM-ESTRO-ESUR-SIOG guidelines on prostate cancer-2020 update. Part 1: screening, diagnosis, and local treatment with curative intent
.
Eur Urol
.
2021
;
79
(
2
):
243
62
.
8.
Cooperberg
MR
,
Brooks
JD
,
Faino
AV
,
Newcomb
LF
,
Kearns
JT
,
Carroll
PR
.
Refined analysis of prostate-specific antigen kinetics to predict prostate cancer active surveillance outcomes
.
Eur Urol
.
2018
;
74
(
2
):
211
7
.
9.
Pastor-Navarro
B
,
Rubio-Briones
J
,
Borque-Fernando
Á
,
Esteban
LM
,
Domínguez-Escrig
JL
,
López-Guerrero
JA
.
Active surveillance in prostate cancer: role of available biomarkers in daily practice
.
Int J Mol Sci
.
2021
;
22
(
12
):
6266
.
10.
van den Bergh
RCN
,
Roemeling
S
,
Roobol
MJ
,
Roobol
W
,
Schröder
FH
,
Bangma
CH
.
Prospective validation of active surveillance in prostate cancer: the PRIAS Study
.
Eur Urol
.
2007
;
52
(
6
):
1560
3
.
11.
Rubio Briones
J
,
Iborra
I
,
Ramírez
M
,
Calatrava
A
,
Collado
A
,
Casanova
J
.
Obligatory information that a patient diagnosed of prostate cancer and candidate for an active surveillance protocol must know
.
Actas Urol Esp
.
2014
;
38
(
9
):
559
65
.
12.
Pound
CR
,
Partin
AW
,
Eisenberger
MA
,
Chan
DW
,
Pearson
JD
,
Walsh
PC
.
Natural history of progression after PSA elevation following radical prostatectomy
.
JAMA
.
1999
;
281
(
17
):
1591
7
.
13.
Song
SH
,
Kim
JK
,
Lee
H
,
Lee
S
,
Hong
SK
,
Byun
SS
.
A single-center long-term experience of active surveillance for prostate cancer:15 years of follow-up
.
Investig Clin Urol
.
2021
;
62
(
1
):
32
8
.
14.
Hamdy
FC
,
Donovan
JL
,
Lane
JA
,
Mason
M
,
Metcalfe
C
,
Holding
P
.
10-Year outcomes after monitoring, surgery, or radiotherapy for localized prostate cancer
.
N Engl J Med
.
2016
;
375
(
15
):
1415
24
.
15.
Rajwa
P
,
Pradere
B
,
Quhal
F
,
Mori
K
,
Laukhtina
E
,
Huebner
NA
.
Reliability of serial prostate magnetic resonance imaging to detect prostate cancer progression during active surveillance: a systematic review and meta-analysis
.
Eur Urol
.
2021
;
80
(
5
):
549
63
.
16.
Carter
HB
,
Pearson
JD
,
Metter
EJ
,
Brant
LJ
,
Chan
DW
,
Andres
R
.
Longitudinal evaluation of prostate-specific antigen levels in men with and without prostate disease
.
JAMA
.
1992
;
267
(
16
):
2215
20
.
17.
Rubio Briones
J
,
Pastor Navarro
B
,
Esteban Escaño
LM
,
Borque Fernando
A
.
Update and optimization of active surveillance in prostate cancer in 2021
.
Actas Urol Esp
.
2021
;
45
:
1
7
.
18.
Newcomb
LF
,
Thompson
IM
,
Boyer
HD
,
Brooks
JD
,
Carroll
PR
,
Cooperberg
MR
.
Outcomes of active surveillance for clinically localized prostate cancer in the prospective, multi-institutional Canary PASS cohort
.
J Urol
.
2016
;
195
(
2
):
313
20
.
19.
Klotz
L
,
Vesprini
D
,
Sethukavalan
P
,
Jethava
V
,
Zhang
L
,
Jain
S
.
Long-term follow-up of a large active surveillance cohort of patients with prostate cancer
.
J Clin Oncol
.
2015
;
33
(
3
):
272
7
.
20.
Ng
MK
,
Van As
N
,
Thomas
K
,
Woode-Amissah
R
,
Horwich
A
.
Prostate-specific antigen (PSA) kinetics in untreated, localized prostate cancer: PSA velocity vs PSA doubling time
.
BJU Int
.
2009
;
103
(
7
):
872
6
.
21.
Ross
PL
,
Mahmud
S
,
Stephenson
AJ
,
Souhami
L
,
Tanguay
S
,
Aprikian
AG
.
Variations in PSA doubling time in patients with prostate cancer on “watchful waiting”: value of short-term PSADT determinations
.
Urology
.
2004
;
64
(
2
):
323
8
.
22.
Carter
HB
,
Morrell
CH
,
Pearson
J
,
Brant
LJ
,
Plato
CC
,
Metter
EJ
.
Estimation of prostatic growth using serial prostate-specific antigen measurements in men with and without prostate disease
.
Cancer Res
.
1992
;
52
(
12
):
3323
8
.
23.
Balakrishnan
AS
,
Cowan
JE
,
Cooperberg
MR
,
Shinohara
K
,
Nguyen
HG
,
Carroll
PR
.
Evaluating the safety of active surveillance: outcomes of deferred radical prostatectomy after an initial period of surveillance
.
J Urol
.
2019
;
202
(
3
):
506
10
.
You do not currently have access to this content.