Prognostic Impact of Time to Undetectable Prostate-Specific Antigen in Patients with Positive Surgical Margins Following Radical Prostatectomy

Kyo Chul Koo, Patrick Tuliao, Christos Komninos, Youngdeuk Choi, Byungha Chung, Sung Joon Hong, Sun Ha Jee, KoonHo Rha

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: The purpose of this article was to determine the impact of time to undetectable prostate-specific antigen (PSA) for predicting biochemical recurrence (BCR) in patients with a positive surgical margin (PSM) following radical prostatectomy (RP). A PSM is an independent predictor of BCR; however, not all patients develop BCR later on.

Methods: A retrospective analysis was conducted on 1,117 consecutive prostate cancer patients who underwent RP without neoadjuvant or adjuvant therapy from July 2005 to December 2009. Of these, 516 (46.2 %) patients without PSMs, and 214 (19.2 %) patients with PSMs who later achieved undetectable PSA, defined as <0.01 ng/ml, were identified. Patients with PSMs were stratified according to time to undetectable PSA dichotomized at 6 weeks and compared with patients without PSMs. Patients with PSMs who did not achieve undetectable PSA were excluded. BCR was defined as two consecutive increases of post-undetectable PSA ≥0.2 ng/ml.

Results: During the median follow-up of 58.2 months, patients with PSMs who achieved undetectable PSA in <6 weeks had comparable 5-year BCR-free survival rates to those without PSMs; however, patients with PSMs who achieved undetectable PSA in ≥6 weeks showed significantly lower rates compared with both patients without PSMs (59.2 vs 74.3 %; p < 0.001) and patients with PSMs who achieved undetectable PSA in <6 weeks (59.2 vs 78.8 %; p = 0.004). Among patients with PSMs, multivariate analysis revealed time to undetectable PSA at ≥6 weeks and seminal vesicle invasion to be independent predictors of BCR. No perioperative factors were associated with undetectable PSA at ≥6 weeks.

Conclusions: Patients with PSMs who achieve undetectable PSA in <6 weeks show comparable risks of BCR to patients with negative surgical margins.

Original languageEnglish
Pages (from-to)693-700
Number of pages8
JournalAnnals of Surgical Oncology
Volume22
Issue number2
DOIs
Publication statusPublished - 2015 Jan 1

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Prostate-Specific Antigen
Prostatectomy
Recurrence
Margins of Excision
Seminal Vesicles
Prostatic Neoplasms
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

@article{6c61a7f55a5b49ef919abf79e2e5ffbc,
title = "Prognostic Impact of Time to Undetectable Prostate-Specific Antigen in Patients with Positive Surgical Margins Following Radical Prostatectomy",
abstract = "Background: The purpose of this article was to determine the impact of time to undetectable prostate-specific antigen (PSA) for predicting biochemical recurrence (BCR) in patients with a positive surgical margin (PSM) following radical prostatectomy (RP). A PSM is an independent predictor of BCR; however, not all patients develop BCR later on.Methods: A retrospective analysis was conducted on 1,117 consecutive prostate cancer patients who underwent RP without neoadjuvant or adjuvant therapy from July 2005 to December 2009. Of these, 516 (46.2 {\%}) patients without PSMs, and 214 (19.2 {\%}) patients with PSMs who later achieved undetectable PSA, defined as <0.01 ng/ml, were identified. Patients with PSMs were stratified according to time to undetectable PSA dichotomized at 6 weeks and compared with patients without PSMs. Patients with PSMs who did not achieve undetectable PSA were excluded. BCR was defined as two consecutive increases of post-undetectable PSA ≥0.2 ng/ml.Results: During the median follow-up of 58.2 months, patients with PSMs who achieved undetectable PSA in <6 weeks had comparable 5-year BCR-free survival rates to those without PSMs; however, patients with PSMs who achieved undetectable PSA in ≥6 weeks showed significantly lower rates compared with both patients without PSMs (59.2 vs 74.3 {\%}; p < 0.001) and patients with PSMs who achieved undetectable PSA in <6 weeks (59.2 vs 78.8 {\%}; p = 0.004). Among patients with PSMs, multivariate analysis revealed time to undetectable PSA at ≥6 weeks and seminal vesicle invasion to be independent predictors of BCR. No perioperative factors were associated with undetectable PSA at ≥6 weeks.Conclusions: Patients with PSMs who achieve undetectable PSA in <6 weeks show comparable risks of BCR to patients with negative surgical margins.",
author = "Koo, {Kyo Chul} and Patrick Tuliao and Christos Komninos and Youngdeuk Choi and Byungha Chung and Hong, {Sung Joon} and Jee, {Sun Ha} and KoonHo Rha",
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Prognostic Impact of Time to Undetectable Prostate-Specific Antigen in Patients with Positive Surgical Margins Following Radical Prostatectomy. / Koo, Kyo Chul; Tuliao, Patrick; Komninos, Christos; Choi, Youngdeuk; Chung, Byungha; Hong, Sung Joon; Jee, Sun Ha; Rha, KoonHo.

In: Annals of Surgical Oncology, Vol. 22, No. 2, 01.01.2015, p. 693-700.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prognostic Impact of Time to Undetectable Prostate-Specific Antigen in Patients with Positive Surgical Margins Following Radical Prostatectomy

AU - Koo, Kyo Chul

AU - Tuliao, Patrick

AU - Komninos, Christos

AU - Choi, Youngdeuk

AU - Chung, Byungha

AU - Hong, Sung Joon

AU - Jee, Sun Ha

AU - Rha, KoonHo

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Background: The purpose of this article was to determine the impact of time to undetectable prostate-specific antigen (PSA) for predicting biochemical recurrence (BCR) in patients with a positive surgical margin (PSM) following radical prostatectomy (RP). A PSM is an independent predictor of BCR; however, not all patients develop BCR later on.Methods: A retrospective analysis was conducted on 1,117 consecutive prostate cancer patients who underwent RP without neoadjuvant or adjuvant therapy from July 2005 to December 2009. Of these, 516 (46.2 %) patients without PSMs, and 214 (19.2 %) patients with PSMs who later achieved undetectable PSA, defined as <0.01 ng/ml, were identified. Patients with PSMs were stratified according to time to undetectable PSA dichotomized at 6 weeks and compared with patients without PSMs. Patients with PSMs who did not achieve undetectable PSA were excluded. BCR was defined as two consecutive increases of post-undetectable PSA ≥0.2 ng/ml.Results: During the median follow-up of 58.2 months, patients with PSMs who achieved undetectable PSA in <6 weeks had comparable 5-year BCR-free survival rates to those without PSMs; however, patients with PSMs who achieved undetectable PSA in ≥6 weeks showed significantly lower rates compared with both patients without PSMs (59.2 vs 74.3 %; p < 0.001) and patients with PSMs who achieved undetectable PSA in <6 weeks (59.2 vs 78.8 %; p = 0.004). Among patients with PSMs, multivariate analysis revealed time to undetectable PSA at ≥6 weeks and seminal vesicle invasion to be independent predictors of BCR. No perioperative factors were associated with undetectable PSA at ≥6 weeks.Conclusions: Patients with PSMs who achieve undetectable PSA in <6 weeks show comparable risks of BCR to patients with negative surgical margins.

AB - Background: The purpose of this article was to determine the impact of time to undetectable prostate-specific antigen (PSA) for predicting biochemical recurrence (BCR) in patients with a positive surgical margin (PSM) following radical prostatectomy (RP). A PSM is an independent predictor of BCR; however, not all patients develop BCR later on.Methods: A retrospective analysis was conducted on 1,117 consecutive prostate cancer patients who underwent RP without neoadjuvant or adjuvant therapy from July 2005 to December 2009. Of these, 516 (46.2 %) patients without PSMs, and 214 (19.2 %) patients with PSMs who later achieved undetectable PSA, defined as <0.01 ng/ml, were identified. Patients with PSMs were stratified according to time to undetectable PSA dichotomized at 6 weeks and compared with patients without PSMs. Patients with PSMs who did not achieve undetectable PSA were excluded. BCR was defined as two consecutive increases of post-undetectable PSA ≥0.2 ng/ml.Results: During the median follow-up of 58.2 months, patients with PSMs who achieved undetectable PSA in <6 weeks had comparable 5-year BCR-free survival rates to those without PSMs; however, patients with PSMs who achieved undetectable PSA in ≥6 weeks showed significantly lower rates compared with both patients without PSMs (59.2 vs 74.3 %; p < 0.001) and patients with PSMs who achieved undetectable PSA in <6 weeks (59.2 vs 78.8 %; p = 0.004). Among patients with PSMs, multivariate analysis revealed time to undetectable PSA at ≥6 weeks and seminal vesicle invasion to be independent predictors of BCR. No perioperative factors were associated with undetectable PSA at ≥6 weeks.Conclusions: Patients with PSMs who achieve undetectable PSA in <6 weeks show comparable risks of BCR to patients with negative surgical margins.

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