INTRODUCTION: Prostatic Specific Antigen (PSA), Bacillus Calmette-Guerin (BCG) increase after intravesical BCG has been reported. The need of prostate biopsy in these patients is object of debate. The aim of our study was to evaluate the effect of intravesical therapy on PSA after transurethral resection (TUR) of nonmuscle-invasive bladder cancer (NMIBC). MATERIALS AND METHODS: Patients undergoing intravesical chemotherapy or immunotherapy for NMIBC were entered. PSA was measured before TUR, before the first and after the sixth instillation, 30 and 90 days after the last instillation. Patients with PSA ≥4 ng/ml or palpable prostate nodule were excluded. RESULTS: Out of 130 patients, 105 were evaluable. PSA increase (mean: 7.15 ng/ml) was detected after TUR and before intravesical therapy in 14 patients (13.3%). Of the remaining 91 patients, 65 (71.4%) received chemotherapy and 26 (28.6%) BCG. Median PSA before and during therapy was 1.80 and 1.97 ng/ml, with a 36% median increase in 66 patients (72.5%) (p = 0.13). No statistically significant difference emerged between chemotherapy and BCG (p = 0.22). PSA higher than 4 ng/ml was detected in six (6.3%) and two (2.1%) patients after chemotherapy and BCG, respectively, and was no more evident at 90 days. DISCUSSION: PSA increase due to intravesical therapy is rare and usually not clinically significant. PSA rising above 4 ng/ml during intravesical treatment was evident only in 8% of patients. PSA before TUR should be available and considered as the basal value. Elevated PSA detected during therapy should be monitored and biopsy proposed only if persisting more than 3 months after the end.

Serretta, V., Scalici Gesolfo, C., Di Maida, F., Caruana, G., Rocchini, L., Moschini, M., et al. (2016). The clinical value of PSA increase during intravesical adjuvant therapy for nonmuscle-invasive bladder cancer. UROLOGIA, 83(3), 145-148 [10.5301/uro.5000189].

The clinical value of PSA increase during intravesical adjuvant therapy for nonmuscle-invasive bladder cancer.

SERRETTA, Vincenzo;SCALICI GESOLFO, Cristina;CARUANA, Giovanni;Simonato, Alchiede
2016

Abstract

INTRODUCTION: Prostatic Specific Antigen (PSA), Bacillus Calmette-Guerin (BCG) increase after intravesical BCG has been reported. The need of prostate biopsy in these patients is object of debate. The aim of our study was to evaluate the effect of intravesical therapy on PSA after transurethral resection (TUR) of nonmuscle-invasive bladder cancer (NMIBC). MATERIALS AND METHODS: Patients undergoing intravesical chemotherapy or immunotherapy for NMIBC were entered. PSA was measured before TUR, before the first and after the sixth instillation, 30 and 90 days after the last instillation. Patients with PSA ≥4 ng/ml or palpable prostate nodule were excluded. RESULTS: Out of 130 patients, 105 were evaluable. PSA increase (mean: 7.15 ng/ml) was detected after TUR and before intravesical therapy in 14 patients (13.3%). Of the remaining 91 patients, 65 (71.4%) received chemotherapy and 26 (28.6%) BCG. Median PSA before and during therapy was 1.80 and 1.97 ng/ml, with a 36% median increase in 66 patients (72.5%) (p = 0.13). No statistically significant difference emerged between chemotherapy and BCG (p = 0.22). PSA higher than 4 ng/ml was detected in six (6.3%) and two (2.1%) patients after chemotherapy and BCG, respectively, and was no more evident at 90 days. DISCUSSION: PSA increase due to intravesical therapy is rare and usually not clinically significant. PSA rising above 4 ng/ml during intravesical treatment was evident only in 8% of patients. PSA before TUR should be available and considered as the basal value. Elevated PSA detected during therapy should be monitored and biopsy proposed only if persisting more than 3 months after the end.
Serretta, V., Scalici Gesolfo, C., Di Maida, F., Caruana, G., Rocchini, L., Moschini, M., et al. (2016). The clinical value of PSA increase during intravesical adjuvant therapy for nonmuscle-invasive bladder cancer. UROLOGIA, 83(3), 145-148 [10.5301/uro.5000189].
File in questo prodotto:
File Dimensione Formato  
Urologia_2016_145.pdf

non disponibili

Descrizione: lavoro per esteso
Dimensione 1.45 MB
Formato Adobe PDF
1.45 MB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10447/203305
Citazioni
  • ???jsp.display-item.citation.pmc??? 3
  • Scopus 3
  • ???jsp.display-item.citation.isi??? 3
social impact