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Ultrasensitive serum prostate specific antigen nadir accurately predicts the risk of early relapse after radical prostatectomy.
J Urol. 2005 Mar; 173(3):777-80.JU

Abstract

PURPOSE

Ultrasensitive prostate specific antigen (PSA) assays allow a lower limit of detection (less than 0.01 ng/ml) than standard PSA assays. In this study we examined the ability of ultrasensitive PSA nadir to predict relapse after radical prostatectomy (RP).

MATERIALS AND METHODS

A total of 906 men treated with RP were followed with PSA measurements at 3, 6 and 12 months, and yearly thereafter. Of the 906 men 545 (60%) with a PSA nadir of less than 0.01 ng/ml or at least 3 followup ultrasensitive PSA measurements underwent analysis and stratification by PSA nadir. Biochemical relapse was defined as 2 consecutive increasing post-nadir PSA measurements of 0.1 ng/ml or greater. The ability of ultrasensitive PSA nadir to predict relapse was assessed by univariate and multivariate analysis.

RESULTS

At a mean followup of 3.1 years 54 of 545 men (9.9%) experienced biochemical relapse with a mean time to relapse of 25.2 months. Relapse rates in men with a PSA nadir of less than 0.01 (423), 0.01 (75), 0.02 (19) and 0.04 or greater ng/ml (28) were 4%, 12%, 16% and 89%, respectively. Men with a nadir of less than 0.01 ng/ml had a significantly lower relapse rate than men with a nadir of 0.01 (p <0.01), 0.02 (p <0.025) or 0.04 or greater ng/ml (p <0.01). Multivariate logistic regression analysis showed that a nadir of 0.01 (p <0.05), 0.02 (p <0.05) and 0.04 or greater ng/ml (p <0.01) independently predicted an increased risk of biochemical relapse compared to a nadir of less than 0.01 ng/ml.

CONCLUSIONS

Ultrasensitive PSA nadir accurately predicts the risk of early biochemical relapse following RP. Men who achieve a nadir of less than 0.01 ng/ml have a low likelihood of early relapse. Higher nadir points may identify candidates for early adjuvant or salvage therapies.

Authors+Show Affiliations

Department of Urology, New York University and Statistics and Social Sciences Group, New York, New York, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15711268

Citation

Shen, Samson, et al. "Ultrasensitive Serum Prostate Specific Antigen Nadir Accurately Predicts the Risk of Early Relapse After Radical Prostatectomy." The Journal of Urology, vol. 173, no. 3, 2005, pp. 777-80.
Shen S, Lepor H, Yaffee R, et al. Ultrasensitive serum prostate specific antigen nadir accurately predicts the risk of early relapse after radical prostatectomy. J Urol. 2005;173(3):777-80.
Shen, S., Lepor, H., Yaffee, R., & Taneja, S. S. (2005). Ultrasensitive serum prostate specific antigen nadir accurately predicts the risk of early relapse after radical prostatectomy. The Journal of Urology, 173(3), 777-80.
Shen S, et al. Ultrasensitive Serum Prostate Specific Antigen Nadir Accurately Predicts the Risk of Early Relapse After Radical Prostatectomy. J Urol. 2005;173(3):777-80. PubMed PMID: 15711268.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ultrasensitive serum prostate specific antigen nadir accurately predicts the risk of early relapse after radical prostatectomy. AU - Shen,Samson, AU - Lepor,Herbert, AU - Yaffee,Robert, AU - Taneja,Samir S, PY - 2005/2/16/pubmed PY - 2005/3/30/medline PY - 2005/2/16/entrez SP - 777 EP - 80 JF - The Journal of urology JO - J. Urol. VL - 173 IS - 3 N2 - PURPOSE: Ultrasensitive prostate specific antigen (PSA) assays allow a lower limit of detection (less than 0.01 ng/ml) than standard PSA assays. In this study we examined the ability of ultrasensitive PSA nadir to predict relapse after radical prostatectomy (RP). MATERIALS AND METHODS: A total of 906 men treated with RP were followed with PSA measurements at 3, 6 and 12 months, and yearly thereafter. Of the 906 men 545 (60%) with a PSA nadir of less than 0.01 ng/ml or at least 3 followup ultrasensitive PSA measurements underwent analysis and stratification by PSA nadir. Biochemical relapse was defined as 2 consecutive increasing post-nadir PSA measurements of 0.1 ng/ml or greater. The ability of ultrasensitive PSA nadir to predict relapse was assessed by univariate and multivariate analysis. RESULTS: At a mean followup of 3.1 years 54 of 545 men (9.9%) experienced biochemical relapse with a mean time to relapse of 25.2 months. Relapse rates in men with a PSA nadir of less than 0.01 (423), 0.01 (75), 0.02 (19) and 0.04 or greater ng/ml (28) were 4%, 12%, 16% and 89%, respectively. Men with a nadir of less than 0.01 ng/ml had a significantly lower relapse rate than men with a nadir of 0.01 (p <0.01), 0.02 (p <0.025) or 0.04 or greater ng/ml (p <0.01). Multivariate logistic regression analysis showed that a nadir of 0.01 (p <0.05), 0.02 (p <0.05) and 0.04 or greater ng/ml (p <0.01) independently predicted an increased risk of biochemical relapse compared to a nadir of less than 0.01 ng/ml. CONCLUSIONS: Ultrasensitive PSA nadir accurately predicts the risk of early biochemical relapse following RP. Men who achieve a nadir of less than 0.01 ng/ml have a low likelihood of early relapse. Higher nadir points may identify candidates for early adjuvant or salvage therapies. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/15711268/Ultrasensitive_serum_prostate_specific_antigen_nadir_accurately_predicts_the_risk_of_early_relapse_after_radical_prostatectomy_ L2 - https://www.jurology.com/doi/full/10.1097/01.ju.0000153619.33446.60?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -