Diagnosis value of prostate specific antigen density (PSAD) and prostate specific antigen (PSA) in bone metastases of prostate cancer among Indonesian population

https://doi.org/10.19106/JMedSci005202202005

Ahmad Zulfan Hendri(1*), Andy Zulfiqqar(2), Indrawarman Soeharjo(3), Raden Danarto(4)

(1) Division of Urology, Department of Surgery, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, 55281, Indonesia.
(2) Division of Urology, Department of Surgery, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, 55281, Indonesia.
(3) Division of Urology, Department of Surgery, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, 55281, Indonesia.
(4) Division of Urology, Department of Surgery, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, 55281, Indonesia.
(*) Corresponding Author

Abstract


Cancer prostate (PCa) is currently reported as the most diagnosed cancer in males. Bone metastases in PCa indicate poor prognosis and the major cause of pain and death. Early diagnosis of metastases is important in PCa management. Prostate specific antigen (PSA) velocity was used to predict overall survival and metastasis-free survival. However, this test should be conducted 2 times, for at least 4 weeks apart. Therefore, a cross-sectional test with higher positive probability value is needed. This study aimed to compare PSA density (PSAD) and PSA level to evaluate patients at risk of bone metastases in Yogyakarta, Indonesia. Aretrospective study with a total subject of 106 patients with (n = 31) and without (n = 75) bone metastases were analyzed. The initial PSA measurement, as well as bone scan and prostate volume, were evaluated in all patients. Bone survey found to be positive in 31/106 (29.2%) patients. The total of 50(47.2%), 10(9.4%) and 46(43.4%) patients had PSA level <50, 50-100 and >100ng/mL, respectively. Furthermore, receiver operating characteristic (ROC) area under the curve of PSAD (0.75) was higher that that ofPSA (0.65).PSAD more than 0.15 indicated sensitivity of 93% and specificity of 38%, while PSA more than 20 ng/mL shown sensitivity 82% and specificity 21%. In conclusion, PSAD level more than 0.15 shows high sensitivity and specificity in causing potential skeletal metastases. Using this PSAD cut-off value, unnecessary investigation canbe avoided.

 


Keywords


prostate cancer; metastatic prostate cancer; PSAD; PSA; bone metastases;

Full Text:

PDF


References

  1. Babjuk M, Burger M, Comperat E, Gontero P, Mostafid A. Guidelines-non-muscle-invasive-bladder-cancer-TaT1-CIS-2018.European Association of Urology 2018;8-30. Available from: https://uroweb.org/wp-content/uploads/EAU-Guidelines-Non-muscle-invasive-Bladder-Cancer-TaT1-CIS-2018.pdf
  2. Falchook AD, Salloum RG, Hendrix LH, Chen RC. Use of bone scan during initial prostate cancer workup, downstream procedures, and associated medicare costs. Radiat Oncol Biol 2014; 89(2):243-8. https://doi.org/10.1016/j.ijrobp.2013.10.023
  3. Nong S, Wen D, Fan C. The relationship of PSA, PSAD and clinicopathological stage in patients with prostate cancer. Chinese J Clin Oncol 2007; 4(5):318-21. https://doi.org/10.1007/s11805-007-0318-y
  4. Stenman UH, Abrahamsson PA, Aus G, Lilja H, Bangma C, Hamdy FC, et al. Boccon-gibod L, Ekman P. Prognostic value of serum markers for prostate cancer. Scand J UrolNephrol Suppl2005; 216: 64-81. https://doi.org/10.1080/03008880510030941
  5. Diamond TH, Higano CS, Smith MR, Guise TA, Singer FR, Singer FR. Osteoporosis in men with prostate carcinoma receiving androgen-deprivation therapy recommendations for diagnosis and therapies. Cancer 2004; 100(5):892-9. https://doi.org/10.1002/cnc2.20056
  6. Bienz M, Saad F. Androgen-deprivation therapy and bone loss in prostate cancer patients: a clinical review. Bonekey Rep 2015; 24:4:716. https://doi.org/10.1038/bonekey.2015.85
  7. Lee CE, Leslie WD, Czaykowski P, Gingerich J, Geirnaert M, Lau YKJ. A comprehensive bone-health management approach for men with prostate cancer receiving androgen deprivation therapy. Curr Oncol 2011; 18(4):e163-72. https://doi.org/10.3747/co.v18i4.746
  8. Sanda MG, Cadeddu JA, Kirby E, Chen R, Crispino T, Fontanarosa J, et al. Clinically localized prostate cancer :AUA)/ASTRO)/SUO Guideline: Part I: risk stratification, shared decision making, and care options.J Urol 2018; 199(3):683-90. https://doi.org/10.1016/j/juro.2017.11.095
  9. Parker C, Gillessen S, Heidenreich A, Horwich A on behalf of the ESMO Guidelines Committee. Cancer of the prostate : ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2015; 26(suppl 5):v69-77. https://doi.org/10.1093/annonc/mdv222
  10. NCCN Guideline for Patients. Prostate cancer. NCCN Foundation, 2018. https://www2.tri-kobe.org/nccn/guideline/urological/english/prostate.pdf
  11. Mottet N, van Den Berg RCN, Briers E, Boueke L, Cornford P, de Santis M, et al. EAU-ESTRO-SUR-SIOG Guidelines on prostate cancer. European Association of Urology, 2019;
  12. Wolff JM, Zimny M, Borchers H, Wildberger J, Buell U, Jakse G. Is prostate-specific antigen a reliab marker bone metastasis patients with new diagnosed cancer prostate? Eur Urol 1998; 33(4):376-81. https://doi.org/10.1159/000019619
  13. Rhoden EL, Torres O, Ramos GZ, Lemos RR, Souto CAV. Value of prostate specific antigen in predicting the existence of bone metastasis in scintigraphy. Int Braz J Urol 2003; 29(2):121-6. https://doi.org/10.1590/S1677-55382003000200005
  14. Saidi S, Georgiev V, Stavridis S, Petrovski D, Dohcev S, Lekovski L, et al. Does prostate specific antigen density correlates with aggressiveness of the prostate cancer? Hippokratia2009; 13(4):232-6.
  15. Magheli A, Rais-Bahrami S, Trock BJ, Humphreys EB, Alan W, Han M, et al. Impactof bodymass index on biochemical recurrence rates after radical prostatectomy: an analysis utilizingpropensity score matching. Urology 2008; 72:1246–51. https://doi.org/10.1016/j.juro.2008.01.032
  16. Kuppusamy S, Quek KF, Rajandram R, Hassan A, Razack A. Revisiting prostate specific antigen density (PSAD): a prospective analysis in predicting the histology of prostate biopsy. IntJ Clin Exp Med 2018; 11(4):3873-9.



DOI: https://doi.org/10.19106/JMedSci005202202005

Article Metrics

Abstract views : 2097 | views : 1748


Bookmark and Share


Copyright (c) 2020 Ahmad Zulfan Hendri, Andy Zulfiqqar, Indrawarman soeharjo, Raden Danarto

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

View My Stats

 

Creative Commons License
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) by  Universitas Gadjah Mada is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Based on a work at http://jurnal.ugm.ac.id/bik/.