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Pre-operative percent free PSA predicts clinical outcomes in patients treated with radical prostatectomy with total PSA levels below 10 ng/ml.
Eur Urol 2006; 49(2):293-302EU

Abstract

INTRODUCTION

To evaluate the association of total prostate specific antigen (T-PSA) and percent free PSA (%F-PSA) with prostate cancer outcomes in patients treated with radical prostatectomy (RP).

METHODS

Pre-operative serum levels of T-PSA and F-PSA were prospectively measured in 402 consecutive patients treated with RP for clinically localized prostate cancer who had T-PSA levels below 10 ng/ml.

RESULTS

T-PSA was not associated with any prostate cancer characteristics or outcomes. Lower %F-PSA was significantly associated with higher percent positive biopsy cores, extracapsular extension, seminal vesicle involvement, lympho-vascular invasion, perineural invasion, positive surgical margins, and higher pathologic Gleason sum. When adjusted for the effects of standard pre-operative features, lower %F-PSA significantly predicted non-organ confined disease, seminal vesicle involvement, lympho-vascular invasion, and biochemical progression. %F-PSA did not retain its association with biochemical progression after adjusting for the effects of standard post-operative features. Based on data from 22 patients with biochemical progression, lower %F-PSA was correlated with shorter T-PSA doubling time after biochemical progression (rho = 0.681, p = 0.010). %F-PSA was lower in patients who failed salvage radiation therapy (p = 0.031) and in patients who developed distant cancer metastases compared to patients who did not (p < 0.001).

CONCLUSIONS

Pre-operative T-PSA is not associated with prostate cancer outcomes after RP when levels are below 10 ng/ml. In contrast, pre-operative %F-PSA is associated with adverse pathologic features, biochemical progression, and features of aggressive disease progression in patients treated with RP and T-PSA levels below 10 ng/ml. %F-PSA may improve pre-operative predictive models for predicting clinical outcomes of patients diagnosed with prostate cancer nowadays.

Authors+Show Affiliations

Department of Urology, The University of Texas Southwestern Medical Center at Dallas, TX 75390-9110, USA. Shahrokh.Shariat@UTSouthwestern.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16387412

Citation

Shariat, Shahrokh F., et al. "Pre-operative Percent Free PSA Predicts Clinical Outcomes in Patients Treated With Radical Prostatectomy With Total PSA Levels Below 10 Ng/ml." European Urology, vol. 49, no. 2, 2006, pp. 293-302.
Shariat SF, Abdel-Aziz KF, Roehrborn CG, et al. Pre-operative percent free PSA predicts clinical outcomes in patients treated with radical prostatectomy with total PSA levels below 10 ng/ml. Eur Urol. 2006;49(2):293-302.
Shariat, S. F., Abdel-Aziz, K. F., Roehrborn, C. G., & Lotan, Y. (2006). Pre-operative percent free PSA predicts clinical outcomes in patients treated with radical prostatectomy with total PSA levels below 10 ng/ml. European Urology, 49(2), pp. 293-302.
Shariat SF, et al. Pre-operative Percent Free PSA Predicts Clinical Outcomes in Patients Treated With Radical Prostatectomy With Total PSA Levels Below 10 Ng/ml. Eur Urol. 2006;49(2):293-302. PubMed PMID: 16387412.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pre-operative percent free PSA predicts clinical outcomes in patients treated with radical prostatectomy with total PSA levels below 10 ng/ml. AU - Shariat,Shahrokh F, AU - Abdel-Aziz,Khaled F, AU - Roehrborn,Claus G, AU - Lotan,Yair, Y1 - 2005/12/20/ PY - 2005/08/11/received PY - 2005/10/25/accepted PY - 2006/1/3/pubmed PY - 2006/6/29/medline PY - 2006/1/3/entrez SP - 293 EP - 302 JF - European urology JO - Eur. Urol. VL - 49 IS - 2 N2 - INTRODUCTION: To evaluate the association of total prostate specific antigen (T-PSA) and percent free PSA (%F-PSA) with prostate cancer outcomes in patients treated with radical prostatectomy (RP). METHODS: Pre-operative serum levels of T-PSA and F-PSA were prospectively measured in 402 consecutive patients treated with RP for clinically localized prostate cancer who had T-PSA levels below 10 ng/ml. RESULTS: T-PSA was not associated with any prostate cancer characteristics or outcomes. Lower %F-PSA was significantly associated with higher percent positive biopsy cores, extracapsular extension, seminal vesicle involvement, lympho-vascular invasion, perineural invasion, positive surgical margins, and higher pathologic Gleason sum. When adjusted for the effects of standard pre-operative features, lower %F-PSA significantly predicted non-organ confined disease, seminal vesicle involvement, lympho-vascular invasion, and biochemical progression. %F-PSA did not retain its association with biochemical progression after adjusting for the effects of standard post-operative features. Based on data from 22 patients with biochemical progression, lower %F-PSA was correlated with shorter T-PSA doubling time after biochemical progression (rho = 0.681, p = 0.010). %F-PSA was lower in patients who failed salvage radiation therapy (p = 0.031) and in patients who developed distant cancer metastases compared to patients who did not (p < 0.001). CONCLUSIONS: Pre-operative T-PSA is not associated with prostate cancer outcomes after RP when levels are below 10 ng/ml. In contrast, pre-operative %F-PSA is associated with adverse pathologic features, biochemical progression, and features of aggressive disease progression in patients treated with RP and T-PSA levels below 10 ng/ml. %F-PSA may improve pre-operative predictive models for predicting clinical outcomes of patients diagnosed with prostate cancer nowadays. SN - 0302-2838 UR - https://www.unboundmedicine.com/medline/citation/16387412/Pre_operative_percent_free_PSA_predicts_clinical_outcomes_in_patients_treated_with_radical_prostatectomy_with_total_PSA_levels_below_10_ng/ml_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0302-2838(05)00775-X DB - PRIME DP - Unbound Medicine ER -