Serum prostate specific antigen is a strong predictor of future prostate growth in men with benign prostatic hyperplasia

Claus Roehrborn, John McConnell, Jaime Bonilla, Sidney Rosenblatt, Perry B. Hudson, Gholem H. Malek, Paul F. Schellhammer, Reginald Bruskewitz, Alvin M. Matsumoto, Lloyd H. Harrison, Harold A. Fuselier, Patrick Walsh, Johnny Roy, Gerald Andriole, Martin Resnick, Joanne Waldstreicher

Research output: Contribution to journalArticle

179 Citations (Scopus)

Abstract

Purpose: We analyze patterns of prostate growth in men diagnosed with benign prostatic hyperplasia (BPH) and treated with placebo during 4 years, and determine which baseline parameters were the strongest predictors of growth. Materials and Methods: A total of 3,040 men were enrolled in the 4- year randomized, placebo controlled Proscar Long-Term Efficacy and Safety study. Of these men a subgroup of 10% underwent pelvic magnetic resonance imaging prostate volume measurement at baseline and yearly thereafter. Absolute and percent volume changes during 4 years were calculated in the 164 placebo treated men in the subgroup. The ability of age, baseline prostate volume and prostate specific antigen (PSA) to predict prostate growth in placebo treated patients was assessed by multiple linear regression analyses, receiver operator characteristics curves, and evaluations of growth stratified by tertiles of baseline serum PSA and decades of life. Results: In placebo treated patients a steady increase in mean plus or minus standard deviation prostate volume from year to year was noted (2.5 ± 6.1, 4.9 ± 6.8, 6.4 ± 8.5 and 7.2 ± 8.8 ml. at years 1, 2, 3 and 4, respectively). Mean volume changes at 4 years ranged from -9 to +30 ml. Mean percent change from baseline ranged from 12.5% to 16.6% for men 50 to 59 years old to those 70 to 79 years old Baseline serum PSA was a strong predictor of growth with 7.4% to 22.0% change at 4 years from the lowest to highest PSA tertiles. Annualized growth rates from baseline were 0.7 ml. per year for PSA 0.2 to 1.3, 2.1 for PSA 1.4 to 3.2 and 3.3 for PSA 3.3 to 9.9 ng./ml. Multiple linear regression analysis showed that serum PSA was a stronger predictor of prostate growth than age or baseline prostate volume. All but 1 man with baseline serum PSA greater than 2.0 ng./ml. had prostate growth during 4 years, and 32.6% of men with serum PSA less than 2.0 exhibited a decrease in volume. Conclusions: Serum PSA is a stronger predictor of growth of the prostate in placebo treated patients than age or baseline prostate volume. Since prostate volume is a risk factor for acute urinary retention and the need for BPH related surgery, the ability of PSA to predict prostate growth may be an important factor when considering individual treatment options for BPH. Such use of PSA represents a shift in paradigm away from focusing solely on symptoms of BPH towards a more comprehensive approach with consideration of predicting and preventing risk factors of BPH related outcomes.

Original languageEnglish (US)
Pages (from-to)13-20
Number of pages8
JournalJournal of Urology
Volume163
Issue number1
StatePublished - 2000

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Prostatic Hyperplasia
Prostate-Specific Antigen
Prostate
Growth
Serum
Placebos
Linear Models
Regression Analysis
Finasteride
Urinary Retention
Magnetic Resonance Imaging

Keywords

  • Magnetic resonance imaging
  • Prostate
  • Prostate-specific antigen
  • Prostatic hyperplasia

ASJC Scopus subject areas

  • Urology

Cite this

Roehrborn, C., McConnell, J., Bonilla, J., Rosenblatt, S., Hudson, P. B., Malek, G. H., ... Waldstreicher, J. (2000). Serum prostate specific antigen is a strong predictor of future prostate growth in men with benign prostatic hyperplasia. Journal of Urology, 163(1), 13-20.

Serum prostate specific antigen is a strong predictor of future prostate growth in men with benign prostatic hyperplasia. / Roehrborn, Claus; McConnell, John; Bonilla, Jaime; Rosenblatt, Sidney; Hudson, Perry B.; Malek, Gholem H.; Schellhammer, Paul F.; Bruskewitz, Reginald; Matsumoto, Alvin M.; Harrison, Lloyd H.; Fuselier, Harold A.; Walsh, Patrick; Roy, Johnny; Andriole, Gerald; Resnick, Martin; Waldstreicher, Joanne.

In: Journal of Urology, Vol. 163, No. 1, 2000, p. 13-20.

Research output: Contribution to journalArticle

Roehrborn, C, McConnell, J, Bonilla, J, Rosenblatt, S, Hudson, PB, Malek, GH, Schellhammer, PF, Bruskewitz, R, Matsumoto, AM, Harrison, LH, Fuselier, HA, Walsh, P, Roy, J, Andriole, G, Resnick, M & Waldstreicher, J 2000, 'Serum prostate specific antigen is a strong predictor of future prostate growth in men with benign prostatic hyperplasia', Journal of Urology, vol. 163, no. 1, pp. 13-20.
Roehrborn, Claus ; McConnell, John ; Bonilla, Jaime ; Rosenblatt, Sidney ; Hudson, Perry B. ; Malek, Gholem H. ; Schellhammer, Paul F. ; Bruskewitz, Reginald ; Matsumoto, Alvin M. ; Harrison, Lloyd H. ; Fuselier, Harold A. ; Walsh, Patrick ; Roy, Johnny ; Andriole, Gerald ; Resnick, Martin ; Waldstreicher, Joanne. / Serum prostate specific antigen is a strong predictor of future prostate growth in men with benign prostatic hyperplasia. In: Journal of Urology. 2000 ; Vol. 163, No. 1. pp. 13-20.
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abstract = "Purpose: We analyze patterns of prostate growth in men diagnosed with benign prostatic hyperplasia (BPH) and treated with placebo during 4 years, and determine which baseline parameters were the strongest predictors of growth. Materials and Methods: A total of 3,040 men were enrolled in the 4- year randomized, placebo controlled Proscar Long-Term Efficacy and Safety study. Of these men a subgroup of 10{\%} underwent pelvic magnetic resonance imaging prostate volume measurement at baseline and yearly thereafter. Absolute and percent volume changes during 4 years were calculated in the 164 placebo treated men in the subgroup. The ability of age, baseline prostate volume and prostate specific antigen (PSA) to predict prostate growth in placebo treated patients was assessed by multiple linear regression analyses, receiver operator characteristics curves, and evaluations of growth stratified by tertiles of baseline serum PSA and decades of life. Results: In placebo treated patients a steady increase in mean plus or minus standard deviation prostate volume from year to year was noted (2.5 ± 6.1, 4.9 ± 6.8, 6.4 ± 8.5 and 7.2 ± 8.8 ml. at years 1, 2, 3 and 4, respectively). Mean volume changes at 4 years ranged from -9 to +30 ml. Mean percent change from baseline ranged from 12.5{\%} to 16.6{\%} for men 50 to 59 years old to those 70 to 79 years old Baseline serum PSA was a strong predictor of growth with 7.4{\%} to 22.0{\%} change at 4 years from the lowest to highest PSA tertiles. Annualized growth rates from baseline were 0.7 ml. per year for PSA 0.2 to 1.3, 2.1 for PSA 1.4 to 3.2 and 3.3 for PSA 3.3 to 9.9 ng./ml. Multiple linear regression analysis showed that serum PSA was a stronger predictor of prostate growth than age or baseline prostate volume. All but 1 man with baseline serum PSA greater than 2.0 ng./ml. had prostate growth during 4 years, and 32.6{\%} of men with serum PSA less than 2.0 exhibited a decrease in volume. Conclusions: Serum PSA is a stronger predictor of growth of the prostate in placebo treated patients than age or baseline prostate volume. Since prostate volume is a risk factor for acute urinary retention and the need for BPH related surgery, the ability of PSA to predict prostate growth may be an important factor when considering individual treatment options for BPH. Such use of PSA represents a shift in paradigm away from focusing solely on symptoms of BPH towards a more comprehensive approach with consideration of predicting and preventing risk factors of BPH related outcomes.",
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author = "Claus Roehrborn and John McConnell and Jaime Bonilla and Sidney Rosenblatt and Hudson, {Perry B.} and Malek, {Gholem H.} and Schellhammer, {Paul F.} and Reginald Bruskewitz and Matsumoto, {Alvin M.} and Harrison, {Lloyd H.} and Fuselier, {Harold A.} and Patrick Walsh and Johnny Roy and Gerald Andriole and Martin Resnick and Joanne Waldstreicher",
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TY - JOUR

T1 - Serum prostate specific antigen is a strong predictor of future prostate growth in men with benign prostatic hyperplasia

AU - Roehrborn, Claus

AU - McConnell, John

AU - Bonilla, Jaime

AU - Rosenblatt, Sidney

AU - Hudson, Perry B.

AU - Malek, Gholem H.

AU - Schellhammer, Paul F.

AU - Bruskewitz, Reginald

AU - Matsumoto, Alvin M.

AU - Harrison, Lloyd H.

AU - Fuselier, Harold A.

AU - Walsh, Patrick

AU - Roy, Johnny

AU - Andriole, Gerald

AU - Resnick, Martin

AU - Waldstreicher, Joanne

PY - 2000

Y1 - 2000

N2 - Purpose: We analyze patterns of prostate growth in men diagnosed with benign prostatic hyperplasia (BPH) and treated with placebo during 4 years, and determine which baseline parameters were the strongest predictors of growth. Materials and Methods: A total of 3,040 men were enrolled in the 4- year randomized, placebo controlled Proscar Long-Term Efficacy and Safety study. Of these men a subgroup of 10% underwent pelvic magnetic resonance imaging prostate volume measurement at baseline and yearly thereafter. Absolute and percent volume changes during 4 years were calculated in the 164 placebo treated men in the subgroup. The ability of age, baseline prostate volume and prostate specific antigen (PSA) to predict prostate growth in placebo treated patients was assessed by multiple linear regression analyses, receiver operator characteristics curves, and evaluations of growth stratified by tertiles of baseline serum PSA and decades of life. Results: In placebo treated patients a steady increase in mean plus or minus standard deviation prostate volume from year to year was noted (2.5 ± 6.1, 4.9 ± 6.8, 6.4 ± 8.5 and 7.2 ± 8.8 ml. at years 1, 2, 3 and 4, respectively). Mean volume changes at 4 years ranged from -9 to +30 ml. Mean percent change from baseline ranged from 12.5% to 16.6% for men 50 to 59 years old to those 70 to 79 years old Baseline serum PSA was a strong predictor of growth with 7.4% to 22.0% change at 4 years from the lowest to highest PSA tertiles. Annualized growth rates from baseline were 0.7 ml. per year for PSA 0.2 to 1.3, 2.1 for PSA 1.4 to 3.2 and 3.3 for PSA 3.3 to 9.9 ng./ml. Multiple linear regression analysis showed that serum PSA was a stronger predictor of prostate growth than age or baseline prostate volume. All but 1 man with baseline serum PSA greater than 2.0 ng./ml. had prostate growth during 4 years, and 32.6% of men with serum PSA less than 2.0 exhibited a decrease in volume. Conclusions: Serum PSA is a stronger predictor of growth of the prostate in placebo treated patients than age or baseline prostate volume. Since prostate volume is a risk factor for acute urinary retention and the need for BPH related surgery, the ability of PSA to predict prostate growth may be an important factor when considering individual treatment options for BPH. Such use of PSA represents a shift in paradigm away from focusing solely on symptoms of BPH towards a more comprehensive approach with consideration of predicting and preventing risk factors of BPH related outcomes.

AB - Purpose: We analyze patterns of prostate growth in men diagnosed with benign prostatic hyperplasia (BPH) and treated with placebo during 4 years, and determine which baseline parameters were the strongest predictors of growth. Materials and Methods: A total of 3,040 men were enrolled in the 4- year randomized, placebo controlled Proscar Long-Term Efficacy and Safety study. Of these men a subgroup of 10% underwent pelvic magnetic resonance imaging prostate volume measurement at baseline and yearly thereafter. Absolute and percent volume changes during 4 years were calculated in the 164 placebo treated men in the subgroup. The ability of age, baseline prostate volume and prostate specific antigen (PSA) to predict prostate growth in placebo treated patients was assessed by multiple linear regression analyses, receiver operator characteristics curves, and evaluations of growth stratified by tertiles of baseline serum PSA and decades of life. Results: In placebo treated patients a steady increase in mean plus or minus standard deviation prostate volume from year to year was noted (2.5 ± 6.1, 4.9 ± 6.8, 6.4 ± 8.5 and 7.2 ± 8.8 ml. at years 1, 2, 3 and 4, respectively). Mean volume changes at 4 years ranged from -9 to +30 ml. Mean percent change from baseline ranged from 12.5% to 16.6% for men 50 to 59 years old to those 70 to 79 years old Baseline serum PSA was a strong predictor of growth with 7.4% to 22.0% change at 4 years from the lowest to highest PSA tertiles. Annualized growth rates from baseline were 0.7 ml. per year for PSA 0.2 to 1.3, 2.1 for PSA 1.4 to 3.2 and 3.3 for PSA 3.3 to 9.9 ng./ml. Multiple linear regression analysis showed that serum PSA was a stronger predictor of prostate growth than age or baseline prostate volume. All but 1 man with baseline serum PSA greater than 2.0 ng./ml. had prostate growth during 4 years, and 32.6% of men with serum PSA less than 2.0 exhibited a decrease in volume. Conclusions: Serum PSA is a stronger predictor of growth of the prostate in placebo treated patients than age or baseline prostate volume. Since prostate volume is a risk factor for acute urinary retention and the need for BPH related surgery, the ability of PSA to predict prostate growth may be an important factor when considering individual treatment options for BPH. Such use of PSA represents a shift in paradigm away from focusing solely on symptoms of BPH towards a more comprehensive approach with consideration of predicting and preventing risk factors of BPH related outcomes.

KW - Magnetic resonance imaging

KW - Prostate

KW - Prostate-specific antigen

KW - Prostatic hyperplasia

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