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The Risk of Distant Metastases and Cancer Specific Survival in Men with Serum Prostate Specific Antigen Values above 100 ng/ml
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
Univ Uppsala Hosp, Reg Canc Ctr, Uppsala, Sweden..
Lund Univ, Dept Translat Med, Urol Canc Res Unit, Lund, Sweden.;Cambridge Hosp, Dept Urol, Cambridge, England..
Univ Uppsala Hosp, Reg Canc Ctr, Uppsala, Sweden.;Karolinska Inst, Dept Med Epidemiol & Biostat, SE-17177 Stockholm, Sweden..
2015 (English)In: Journal of Urology, ISSN 0022-5347, E-ISSN 1527-3792, Vol. 194, no 6, 1594-1600 p.Article in journal (Refereed) Published
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Abstract [en]

Purpose: Current EAU (European Association of Urology) guidelines state that prostate specific antigen 100 ng/ml or greater at diagnosis indicates metastatic disease. We examined the association of prostate specific antigen 100 ng/ml or greater at diagnosis with distant metastasis and prostate cancer specific survival. Material and Methods: A total of 15,635 men with prostate cancer diagnosed between 1998 and 2009 who were identified in PCBaSe (Prostate Cancer Data Base Sweden 2.0) were included in a population based registry study. Prostate cancer specific survival was compared among 3 groups, including 1,879 men with prostate specific antigen 100 ng/ml or greater and negative imaging (MO), 5,642 with distant metastases on imaging (M1) and prostate specific antigen 100 ng/ml or greater, and 3,828 with M1 and prostate specific antigen less than 100 ng/ml. A fourth group consisted of 4,286 men with prostate specific antigen 100 ng/ml or greater who had not undergone imaging (Mx). The latter men were not included in the assessment of survival. Results: Of 7,521 men with prostate specific antigen 100 ng/ml or greater who underwent imaging for staging 75% were classified with M1 disease. Only 59% of 3,527 men with prostate specific antigen 100 to 300 mg/ml had distant metastases on imaging. Five-year prostate cancer specific survival was 72% (95% CI 70-74) in men with prostate specific antigen 100 ng/ml or greater and MO, 24% (95% CI 23-25) in men with prostate specific antigen 100 ng/ml or greater and Ml, and 39% (95% CI 37-40) in men with prostate specific antigen less than 100 ng/ml and Ml. Conclusions: A fourth of men with prostate specific antigen 100 ng/ml or greater did not have distant metastases. They had twofold to threefold higher 5-year survival than men with distant metastases on imaging. Our findings strongly suggest that using prostate specific antigen 100 ng/ml or greater as an indicator of metastatic disease should be reconsidered.

Place, publisher, year, edition, pages
2015. Vol. 194, no 6, 1594-1600 p.
Keyword [en]
prostatic neoplasms, adenocarcinoma, prostate-specific antigen, neoplasm metastasis, Sweden
National Category
Urology and Nephrology Cancer and Oncology
Identifiers
URN: urn:nbn:se:uu:diva-270951DOI: 10.1016/j.juro.2015.07.082ISI: 000365985900020PubMedID: 26192253OAI: oai:DiVA.org:uu-270951DiVA: diva2:890881
Funder
Swedish Research Council, 825-2012-5047Swedish Cancer Society, 2012/475
Available from: 2016-01-05 Created: 2016-01-05 Last updated: 2017-12-01Bibliographically approved

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Stattin, Karl

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