Characterization and predictors of prostate specific antigen progression rates after radical retropubic prostatectomy

Michael O. Koch, Richard S. Foster, Bradley Bell, Stephen Beck, Liang Cheng, Dipen Parekh, Sin Ho Jung

Research output: Contribution to journalArticle

31 Scopus citations

Abstract

Purpose: Detectable serum prostate specific antigen (PSA) after radical prostatectomy indicates recurrent disease and treatment failure. We characterized PSA recurrence after prostatectomy and identified predictors of rapid PSA progression. Materials and Methods: We retrospectively reviewed the medical records of 165 patients with detectable PSA after radical prostatectomy to characterize the rate of PSA increase and correlate this rate with the possible predictors of rapid PSA progression known at prostatectomy. Results: For a median of 48 months postoperatively we followed 142 patients with PSA recurrence after radical prostatectomy who received no immediate adjuvant therapy. PSA doubling time was less than 6, greater than 6, 12, 18 and 24 months in 46%, 54%, 18%, 11% and 9% of cases, while time to PSA 50 ng./ml. was greater than 5, 10, 15 and 20 years in 69%, 34%, 22% and 9%, respectively. Univariate and multivariate analyses revealed that rapid PSA doubling time was associated with Gleason secondary grade, Gleason score and time to initial detectable PSA (p = 0.019, 0.031 and 0.0001, and p = 0.043, 0.045 and 0.0001, respectively). Conclusions: PSA recurrence progresses at a greatly variable rate and many recurrences progress slowly with a long doubling time. Gleason secondary grade and score appear to be predictive of rapid PSA progression. No other pathological features were predictive of rapid PSA progression.

Original languageEnglish (US)
Pages (from-to)749-753
Number of pages5
JournalJournal of Urology
Volume164
Issue number3 I
DOIs
StatePublished - Sep 2000

Keywords

  • Prostate
  • Prostate-specific antigen
  • Prostatic neoplasms
  • Recurrence

ASJC Scopus subject areas

  • Urology

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