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The long-term clinical impact of biochemical recurrence of prostate cancer 5 or more years after radical prostatectomy.
J Urol. 2003 Nov; 170(5):1872-6.JU

Abstract

PURPOSE

Information regarding the clinical impact of delayed (5 years or greater) biochemical failure (BF) after radical prostatectomy (RP) is lacking. We undertook an investigation to differentiate the innocuous recurrence of serum prostate specific antigen (PSA) from that which heralds an eventual clinical failure (CF), and to determine if there is a period following RP when a patient is cured of clinical disease.

MATERIALS AND METHODS

Men with clinically localized prostate cancer (PCA) undergoing RP (1987 to 1995) were identified from our longitudinal PCA registry. Outcome measurements were based on the detection of post-RP serum PSA 0.4 ng/ml or greater, clinical identification of cancer recurrence and disease related death.

RESULTS

Following RP in 3,903 eligible men, 33% had a detectable PSA (median followup 8.8 years). Of these BFs 27% occurred after 5 or more disease-free years. Currently, 29% of all men with BF have clinical evidence of PCA, with 8% dying of PCA (median actuarial survival time from CF to death 9.8 years). Progression from BF to CF was not significantly altered by the disease-free interval (p = 0.544). A PSA doubling time less than 12 months significantly increased the risk of CF regardless of the interval from surgery. Risk factors for BF were significant throughout the duration of followup.

CONCLUSIONS

Patients are at prolonged risk for BF and CF following RP. Regardless of the timing of the initial PSA recurrence the PSA doubling time is the most powerful predictor of progression, stratifying patients with BF into high and low risk groups for CF.

Authors+Show Affiliations

Department of Urology, Mayo Clinic, 200 First Street S.W., Rochester, MN 55905, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

14532796

Citation

Ward, John F., et al. "The Long-term Clinical Impact of Biochemical Recurrence of Prostate Cancer 5 or More Years After Radical Prostatectomy." The Journal of Urology, vol. 170, no. 5, 2003, pp. 1872-6.
Ward JF, Blute ML, Slezak J, et al. The long-term clinical impact of biochemical recurrence of prostate cancer 5 or more years after radical prostatectomy. J Urol. 2003;170(5):1872-6.
Ward, J. F., Blute, M. L., Slezak, J., Bergstralh, E. J., & Zincke, H. (2003). The long-term clinical impact of biochemical recurrence of prostate cancer 5 or more years after radical prostatectomy. The Journal of Urology, 170(5), 1872-6.
Ward JF, et al. The Long-term Clinical Impact of Biochemical Recurrence of Prostate Cancer 5 or More Years After Radical Prostatectomy. J Urol. 2003;170(5):1872-6. PubMed PMID: 14532796.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The long-term clinical impact of biochemical recurrence of prostate cancer 5 or more years after radical prostatectomy. AU - Ward,John F, AU - Blute,Michael L, AU - Slezak,Jeffrey, AU - Bergstralh,Erik J, AU - Zincke,Horst, PY - 2003/10/9/pubmed PY - 2003/12/3/medline PY - 2003/10/9/entrez SP - 1872 EP - 6 JF - The Journal of urology JO - J Urol VL - 170 IS - 5 N2 - PURPOSE: Information regarding the clinical impact of delayed (5 years or greater) biochemical failure (BF) after radical prostatectomy (RP) is lacking. We undertook an investigation to differentiate the innocuous recurrence of serum prostate specific antigen (PSA) from that which heralds an eventual clinical failure (CF), and to determine if there is a period following RP when a patient is cured of clinical disease. MATERIALS AND METHODS: Men with clinically localized prostate cancer (PCA) undergoing RP (1987 to 1995) were identified from our longitudinal PCA registry. Outcome measurements were based on the detection of post-RP serum PSA 0.4 ng/ml or greater, clinical identification of cancer recurrence and disease related death. RESULTS: Following RP in 3,903 eligible men, 33% had a detectable PSA (median followup 8.8 years). Of these BFs 27% occurred after 5 or more disease-free years. Currently, 29% of all men with BF have clinical evidence of PCA, with 8% dying of PCA (median actuarial survival time from CF to death 9.8 years). Progression from BF to CF was not significantly altered by the disease-free interval (p = 0.544). A PSA doubling time less than 12 months significantly increased the risk of CF regardless of the interval from surgery. Risk factors for BF were significant throughout the duration of followup. CONCLUSIONS: Patients are at prolonged risk for BF and CF following RP. Regardless of the timing of the initial PSA recurrence the PSA doubling time is the most powerful predictor of progression, stratifying patients with BF into high and low risk groups for CF. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/14532796/The_long_term_clinical_impact_of_biochemical_recurrence_of_prostate_cancer_5_or_more_years_after_radical_prostatectomy_ L2 - https://www.jurology.com/doi/10.1097/01.ju.0000091876.13656.2e?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -