Persistently elevated prostate-specific antigen at six weeks after radical prostatectomy helps in early identification of patients who are likely to recur - Abstract

The Academic Department of Urology, Pathology and Statistics of La Pitié-Salpétrière, Groupe Hospitalo-Universitaire EST, Assistance-Publique Hôpitaux de Paris, 47-83 bvd de l'Hôpital, 75013, Paris, France.

 

To determine the prognostic factors of biochemical recurrence in patients who failed to achieve an undetectable prostate-specific antigen (PSA) after radical prostatectomy (RP) for prostate cancer.

We reviewed data on 240 men who underwent RP as first-line treatment and who had a PSA assay available at 6 weeks after surgery. Persistent detectable PSA was defined as a PSA level ≥0.1 ng/ml at 6 weeks after surgery.

Overall, 83 men presented persistently elevated PSA after RP and 81 had a biochemical recurrence. Median follow-up was 44 months. In univariate analysis, these factors were associated with biochemical recurrence: preoperative PSA level (P < 0.0001), biopsy and pathologic Gleason score (P < 0.001), capsular involvement (P = 0.0001), positive surgical margins (P < 0.0001), pathological stage ≥T3 (P = 0.0001), and detectable post-operative PSA ≥0.1 ng/ml (P = 0.0001). In a multivariate analysis, only the detectable post-operative PSA level ≥0.1 ng/mL (P = 0.001), positive surgical margins (P = 0.002), and pathological stage ≥T3 (P < 0.001) were significant. The individual, five-year, PSA-free survival rate for men with post-operative PSA < 0.1 ng/ml and ≥0.1 ng/ml were 59 and 42%, respectively (P < 0.001).

A majority of patients who failed to achieve an undetectable PSA after surgery had a subsequent biochemical recurrence in the outcome. A systematic PSA assay 6 weeks after RP could be useful to early identify patients who are likely to recur.

Written by:
Audenet F, Seringe E, Drouin SJ, Comperat E, Cussenot O, Bitker MO, Rouprêt M.   Are you the author?

Reference: World J Urol. 2011 Jun 3. Epub ahead of print.
doi: 10.1007/s00345-011-0707-y

PubMed Abstract
PMID: 21638225

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