Postoperative early ultrasensitive prostate-specific antigen identifies patients at risk for biochemical recurrence in margin positive prostate cancers: a single-center study.

Abstract

OBJECTIVE:

To identify predictors for biochemical recurrence among patients with positive surgical margins (RM1) after radical prostatectomy and to examine the effect of ultrasensitive prostate-specific antigen measured early after prostatectomy on biochemical recurrence.

METHODS:

We identified 705 patients with prostate cancer who were treated with radical prostatectomy without preoperative hormonal therapy at our institution between 2000 and 2014. The patients with RM1 who had a postoperative prostate-specific antigen <0.2 ng/ml without lymph node metastasis were evaluated for biochemical recurrence-free survival. Survival rates were calculated using the Kaplan-Meier method. The Cox regression model was used for multivariate analysis. The prediction of biochemical recurrence was assessed using area under the curve of the receiver operating characteristic.

RESULTS:

Among the 705 patients, 190 (27%) had RM1. Biochemical recurrence was evaluated in 164 patients, excluding 26 patients who underwent adjuvant therapy with or without lymph node metastasis. With a median follow-up of 55 months, the biochemical recurrence-free survival rate of the entire RM1 cohort was 78% at 2 years and 64% at 4 years. The multivariate analysis revealed that postoperative early ultrasensitive prostate-specific antigen >0.02 ng/ml was the significant risk factor for biochemical recurrence (hazard ratio 13.10). Meanwhile, the patients with postoperative early ultrasensitive prostate-specific antigen <0.01 ng/ml had a significantly lower risk for biochemical recurrence (hazard ratio 0.12). Area under the curve for the postoperative early ultrasensitive prostate-specific antigen value to predict biochemical recurrence was 0.789.

CONCLUSIONS:

The ultrasensitive prostate-specific antigen value measured early after prostatectomy was the potent predictor of biochemical recurrence among the patients with RM1.

• Authors: Koji Hatano, Takuya Okusa, Yu Ishizuya, Yasutomo Nakai, Masashi Nakayama, Ken-Ichi Kakimoto, Kazuo Nishimura
• Journal: Japanese journal of clinical oncology (Jpn J Clin Oncol) Vol. 47 Issue 1 Pg. 74-79 (Jan 2017) ISSN: 1465-3621 [Electronic] England
• PMID: 27733509 (Publication Type: Journal Article)
• Copyright: © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: [email protected].

Chemical References

• Prostate-Specific Antigen

Topics

• Aged
• Area Under Curve
• Disease Progression
• Humans
• Kaplan-Meier Estimate
• Lymphatic Metastasis
• Male
• Middle Aged
• Multivariate Analysis
• Neoplasm Recurrence, Local
• Postoperative Period
• Proportional Hazards Models
• Prostate-Specific Antigen (blood)
• Prostatectomy
• Prostatic Neoplasms (diagnosis, mortality, surgery)
• ROC Curve
• Retrospective Studies
• Risk Factors