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 language | English |
|---|---|
| Pages (from-to) | 693-700 |
| Number of pages | 8 |
| Journal | Annals of Surgical Oncology |
| Volume | 22 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 2015 Jan 1 |
Fingerprint
All Science Journal Classification (ASJC) codes
- Surgery
- Oncology
Cite this
}
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 journal › Article
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.
UR - http://www.scopus.com/inward/record.url?scp=84921018391&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84921018391&partnerID=8YFLogxK
U2 - 10.1245/s10434-014-4057-z
DO - 10.1245/s10434-014-4057-z
M3 - Article
C2 - 25190131
AN - SCOPUS:84921018391
VL - 22
SP - 693
EP - 700
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
SN - 1068-9265
IS - 2
ER -