PSA bounce after brachytherapy with permanent seed implantation for prostate cancer

PURPOSE: To evaluate prostate specific antigen (PSA) bounce that may occur as a time PSA rise phenomenon during follow up period after brachytherapy (BT) with permanent seed implantation for prostate cancer. Seven hundred and forty-six patients had undergone BT from November 2003 to April 2007 in a single institute, and of 130 patients who did not receive hormone therapy and had minimal 3-year follow up are analyzed. PSA bounce was defined as a rise of at least 0.4 ng/ml with spontaneous return to pre-bounce level or lower.

RESULT: Among the 130 patients, 40 patients (30.8%) developed PSA bounce, and median time to PSA bounce was 18 months after the BT. With univariate analysis, younger patients (P = 0.027) and larger prostate (P = 0.030) had statistically significant correlation with PSA bounce. With multivariate analysis, younger patients were identified as only independent factor for predicting PSA bounce. Eight patients out of 130 patients (6.2%) triggered the Phoenix definition (nadir + 2 ng/ml) of PSA failure, however, clinical failure was seen only in 3 patients, and other 5 patients were considered as PSA bounce.

CONCLUSION: PSA bounce is likely to occur in younger patients within 3 years after BT. It is clinically important to distinguish PSA bounce from PSA failure during following period after BT.

Written by:
Yagi Y, Namitome R, Kono Y, Nishiyama T, Toya K, Yorozu A, Saito S. Are you the author?
The Department of Urology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.

Reference: Nihon Hinyokika Gakkai Zasshi. 2011 Sep;102(5):669-74.

PubMed Abstract
PMID: 22191274

Article in Japanese.

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