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Predictors of short postoperative prostate-specific antigen doubling time for patients diagnosed during PSA era.
Urology. 2005 Mar; 65(3):528-32.U

Abstract

OBJECTIVES

To determine the preoperative and postoperative predictors of a short prostate-specific antigen (PSA) doubling time (PSADT) after radical prostatectomy for patients diagnosed during the PSA era.

METHODS

Between 1989 and 2003, 1785 men underwent radical prostatectomy for 2002 American Joint Committee on Cancer (AJCC) Stage T1c or T2 prostate cancer. Of these men, 205 had documented PSA failure. The PSADT was calculated by assuming first-order kinetics and using a minimum of two detectable postoperative PSA measurements after a previous undetectable level. Multivariable logistic regression analyses were performed to determine the significant preoperative and postoperative predictors of a PSADT of less than 6 months.

RESULTS

Patients with a greater biopsy Gleason score (P = 0.006), greater preoperative risk group (P = 0.002), greater prostatectomy Gleason score (P = 0.0006), greater 2002 AJCC pathologic stage (P = 0.01), or shorter time to postoperative PSA failure (P = 0.04) were more likely to have a shorter PSADT. Using multivariable analysis, high-risk disease (P = 0.0001) was the only preoperative factor that remained an independent significant predictor of a PSADT of less than 6 months. Of the postoperative factors, a prostatectomy Gleason score of 8 to 10 (P = 0.002), 2002 AJCC pathologic Stage T3b (P = 0.03), and time to PSA failure of less than 2 years (P = 0.05) remained significant independent predictors of a PSADT of less than 6 months.

CONCLUSIONS

High-risk disease preoperatively and a prostatectomy Gleason score of 8 to 10, seminal vesicle invasion, or a time to PSA failure of less than 2 years postoperatively were significant independent indicators of developing a postoperative PSADT of less than 6 months. For these men, trials studying systemic therapy in addition to radical prostatectomy are needed.

Authors+Show Affiliations

Department of Urology, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. dlin4@partners.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15780370

Citation

Lin, Darlene D., et al. "Predictors of Short Postoperative Prostate-specific Antigen Doubling Time for Patients Diagnosed During PSA Era." Urology, vol. 65, no. 3, 2005, pp. 528-32.
Lin DD, Schultz D, Renshaw AA, et al. Predictors of short postoperative prostate-specific antigen doubling time for patients diagnosed during PSA era. Urology. 2005;65(3):528-32.
Lin, D. D., Schultz, D., Renshaw, A. A., Rubin, M. A., Richie, J. P., & D'Amico, A. V. (2005). Predictors of short postoperative prostate-specific antigen doubling time for patients diagnosed during PSA era. Urology, 65(3), 528-32.
Lin DD, et al. Predictors of Short Postoperative Prostate-specific Antigen Doubling Time for Patients Diagnosed During PSA Era. Urology. 2005;65(3):528-32. PubMed PMID: 15780370.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictors of short postoperative prostate-specific antigen doubling time for patients diagnosed during PSA era. AU - Lin,Darlene D, AU - Schultz,Delray, AU - Renshaw,Andrew A, AU - Rubin,Mark A, AU - Richie,Jerome P, AU - D'Amico,Anthony V, PY - 2004/04/19/received PY - 2004/10/01/accepted PY - 2005/3/23/pubmed PY - 2005/12/13/medline PY - 2005/3/23/entrez SP - 528 EP - 32 JF - Urology JO - Urology VL - 65 IS - 3 N2 - OBJECTIVES: To determine the preoperative and postoperative predictors of a short prostate-specific antigen (PSA) doubling time (PSADT) after radical prostatectomy for patients diagnosed during the PSA era. METHODS: Between 1989 and 2003, 1785 men underwent radical prostatectomy for 2002 American Joint Committee on Cancer (AJCC) Stage T1c or T2 prostate cancer. Of these men, 205 had documented PSA failure. The PSADT was calculated by assuming first-order kinetics and using a minimum of two detectable postoperative PSA measurements after a previous undetectable level. Multivariable logistic regression analyses were performed to determine the significant preoperative and postoperative predictors of a PSADT of less than 6 months. RESULTS: Patients with a greater biopsy Gleason score (P = 0.006), greater preoperative risk group (P = 0.002), greater prostatectomy Gleason score (P = 0.0006), greater 2002 AJCC pathologic stage (P = 0.01), or shorter time to postoperative PSA failure (P = 0.04) were more likely to have a shorter PSADT. Using multivariable analysis, high-risk disease (P = 0.0001) was the only preoperative factor that remained an independent significant predictor of a PSADT of less than 6 months. Of the postoperative factors, a prostatectomy Gleason score of 8 to 10 (P = 0.002), 2002 AJCC pathologic Stage T3b (P = 0.03), and time to PSA failure of less than 2 years (P = 0.05) remained significant independent predictors of a PSADT of less than 6 months. CONCLUSIONS: High-risk disease preoperatively and a prostatectomy Gleason score of 8 to 10, seminal vesicle invasion, or a time to PSA failure of less than 2 years postoperatively were significant independent indicators of developing a postoperative PSADT of less than 6 months. For these men, trials studying systemic therapy in addition to radical prostatectomy are needed. SN - 1527-9995 UR - https://www.unboundmedicine.com/medline/citation/15780370/Predictors_of_short_postoperative_prostate_specific_antigen_doubling_time_for_patients_diagnosed_during_PSA_era_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0090-4295(04)01238-5 DB - PRIME DP - Unbound Medicine ER -