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01-04-2012 | Original Article

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

Authors: François Audenet, Elise Seringe, Sarah J. Drouin, Eva Comperat, Olivier Cussenot, Marc-Olivier Bitker, Morgan Rouprêt

Published in: World Journal of Urology | Issue 2/2012

Abstract

Objective

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.

Materials and methods

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.

Results

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).

Conclusions

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.

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Title: Persistently elevated prostate-specific antigen at six weeks after radical prostatectomy helps in early identification of patients who are likely to recur
Authors: François Audenet
Elise Seringe
Sarah J. Drouin
Eva Comperat
Olivier Cussenot
Marc-Olivier Bitker
Morgan Rouprêt
Publication date: 01-04-2012
Publisher: Springer-Verlag
Published in: World Journal of Urology / Issue 2/2012
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-011-0707-y

At a glance: The STEP trials

Springer Medicine

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

Abstract

Objective

Materials and methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Materials and methods

Results

Conclusions

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