Topics:
Radiation Oncology • Genitourinary Cancers
Given the biochemical failure definition of PSA nadir+2 ng/mL, how do you approach a PSA bounce of magnitude 2 ng/mL or higher?
If they return to nadir, when (if ever) are they considered to have failed?
Answer from: Radiation Oncologist at Academic Institution
If a PSA bounces >2 points then PSA decreases subsequently without any treatment, I do *not* consider these patients to have failed. This does occur in the clinic occasionally.
Thankfully, when patients have rising PSAs after RT, there usually is not an urgency to start salvage treatment. When a...
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Answer from: Radiation Oncologist at Community Practice
ASTRO definition of biochemical failure has high specificity (about 80%) and high negative predictive value ( 90%) but lower sensitivity and positive predictive value (40% or so) . It is good for reporting to avoid incorrect reporting. A PSA bounce can effect the less than 2 years reporting nu...