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Long-term oncological outcomes of men undergoing radical prostatectomy with preoperative prostate-specific antigen <2.5 ng/ml and 2.5-4 ng/ml.
Urol Oncol. 2013 Nov; 31(8):1527-32.UO

Abstract

OBJECTIVES

Prostate-specific antigen (PSA) screening has increased the detection of small, organ-confined tumors, and studies suggest that these patients may have favorable outcomes following radical prostatectomy (RP). To date, there are limited data available on the outcomes of patients diagnosed with low PSA (≤ 4 ng/ml) who underwent RP. This study aimed to evaluate long-term oncological outcomes of patients undergoing RP with preoperative PSA <2.5 and 2.5-4 ng/ml compared with PSA 4.1-10 ng/ml.

MATERIALS AND METHODS

Data were analyzed from 3,621 men who underwent RP between 1988 and 2010 at our institution. Patients were stratified into 3 PSA groups: <2.5 ng/ml (n = 280), 2.5-4 ng/ml (n = 563), and 4.1-10 ng/ml (n = 2,778). Patient and disease characteristics were compared. Overall, biochemical disease-free (bDFS), and PCa-specific survivals were analyzed and compared between the groups. Multivariable analyses were conducted using proportional hazards model.

RESULTS

Compared with the 4.1-10 ng/ml PSA group, Gleason score >7, extracapsular extension, and non-organ-confined disease were less common in patients with PSA ≤ 4 ng/ml (all P < 0.001). The incidence of organ-confined disease was similar between the PSA < 2.5 and 2.5-4 ng/ml groups while perineural invasion (P = 0.050) and Gleason score ≥ 7 (P = 0.026) were more common in the 2.5-4 ng/ml PSA group. Estimated 10-year overall and PCa-specific survivals were comparable across all PSA groups, whereas bDFS was significantly lower in PSA 4.1-10 group (P < 0.001). bDFS was not statistically different between PSA <2.5 and 2.5-4 groups (P = 0.300). 10-year bDFS were 59.0%, 70.1%, and 76.4% in PSA 4.1-10, 2.5-4, and <2.5, respectively. For the PSA ≤ 4 ng/ml groups, age, race, margin status, pathologic stage, but not PSA were independent predictors of bDFS, whereas age, pathologic Gleason, and biochemical recurrence were associated with overall survival.

CONCLUSIONS

Long-term oncological outcomes (overall, bDFS, PCa-specific survivals) of patients presenting with low PSA (≤ 4 ng/ml) were excellent in this study. Compared with PSA 4.1-10 ng/ml, patients presenting with PSA ≤ 4 ng/ml had better bDFS outcomes. However, there was no difference in long-term outcomes between PSA <2.5 and 2.5-4 ng/ml.

Authors+Show Affiliations

Division of Urology, Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22795501

Citation

Qi, Peter, et al. "Long-term Oncological Outcomes of Men Undergoing Radical Prostatectomy With Preoperative Prostate-specific Antigen <2.5 Ng/ml and 2.5-4 Ng/ml." Urologic Oncology, vol. 31, no. 8, 2013, pp. 1527-32.
Qi P, Tsivian M, Abern MR, et al. Long-term oncological outcomes of men undergoing radical prostatectomy with preoperative prostate-specific antigen <2.5 ng/ml and 2.5-4 ng/ml. Urol Oncol. 2013;31(8):1527-32.
Qi, P., Tsivian, M., Abern, M. R., Bañez, L. L., Tang, P., Moul, J. W., & Polascik, T. J. (2013). Long-term oncological outcomes of men undergoing radical prostatectomy with preoperative prostate-specific antigen <2.5 ng/ml and 2.5-4 ng/ml. Urologic Oncology, 31(8), 1527-32. https://doi.org/10.1016/j.urolonc.2012.06.003
Qi P, et al. Long-term Oncological Outcomes of Men Undergoing Radical Prostatectomy With Preoperative Prostate-specific Antigen <2.5 Ng/ml and 2.5-4 Ng/ml. Urol Oncol. 2013;31(8):1527-32. PubMed PMID: 22795501.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term oncological outcomes of men undergoing radical prostatectomy with preoperative prostate-specific antigen <2.5 ng/ml and 2.5-4 ng/ml. AU - Qi,Peter, AU - Tsivian,Matvey, AU - Abern,Michael R, AU - Bañez,Lionel L, AU - Tang,Ping, AU - Moul,Judd W, AU - Polascik,Thomas J, Y1 - 2012/07/12/ PY - 2012/04/27/received PY - 2012/06/12/revised PY - 2012/06/13/accepted PY - 2012/7/17/entrez PY - 2012/7/17/pubmed PY - 2014/8/5/medline KW - Long-term KW - Low PSA KW - Oncological outcomes KW - Prostate cancer KW - Radical prostatectomy KW - Survival SP - 1527 EP - 32 JF - Urologic oncology JO - Urol Oncol VL - 31 IS - 8 N2 - OBJECTIVES: Prostate-specific antigen (PSA) screening has increased the detection of small, organ-confined tumors, and studies suggest that these patients may have favorable outcomes following radical prostatectomy (RP). To date, there are limited data available on the outcomes of patients diagnosed with low PSA (≤ 4 ng/ml) who underwent RP. This study aimed to evaluate long-term oncological outcomes of patients undergoing RP with preoperative PSA <2.5 and 2.5-4 ng/ml compared with PSA 4.1-10 ng/ml. MATERIALS AND METHODS: Data were analyzed from 3,621 men who underwent RP between 1988 and 2010 at our institution. Patients were stratified into 3 PSA groups: <2.5 ng/ml (n = 280), 2.5-4 ng/ml (n = 563), and 4.1-10 ng/ml (n = 2,778). Patient and disease characteristics were compared. Overall, biochemical disease-free (bDFS), and PCa-specific survivals were analyzed and compared between the groups. Multivariable analyses were conducted using proportional hazards model. RESULTS: Compared with the 4.1-10 ng/ml PSA group, Gleason score >7, extracapsular extension, and non-organ-confined disease were less common in patients with PSA ≤ 4 ng/ml (all P < 0.001). The incidence of organ-confined disease was similar between the PSA < 2.5 and 2.5-4 ng/ml groups while perineural invasion (P = 0.050) and Gleason score ≥ 7 (P = 0.026) were more common in the 2.5-4 ng/ml PSA group. Estimated 10-year overall and PCa-specific survivals were comparable across all PSA groups, whereas bDFS was significantly lower in PSA 4.1-10 group (P < 0.001). bDFS was not statistically different between PSA <2.5 and 2.5-4 groups (P = 0.300). 10-year bDFS were 59.0%, 70.1%, and 76.4% in PSA 4.1-10, 2.5-4, and <2.5, respectively. For the PSA ≤ 4 ng/ml groups, age, race, margin status, pathologic stage, but not PSA were independent predictors of bDFS, whereas age, pathologic Gleason, and biochemical recurrence were associated with overall survival. CONCLUSIONS: Long-term oncological outcomes (overall, bDFS, PCa-specific survivals) of patients presenting with low PSA (≤ 4 ng/ml) were excellent in this study. Compared with PSA 4.1-10 ng/ml, patients presenting with PSA ≤ 4 ng/ml had better bDFS outcomes. However, there was no difference in long-term outcomes between PSA <2.5 and 2.5-4 ng/ml. SN - 1873-2496 UR - https://www.unboundmedicine.com/medline/citation/22795501/Long_term_oncological_outcomes_of_men_undergoing_radical_prostatectomy_with_preoperative_prostate_specific_antigen_<2_5_ng/ml_and_2_5_4_ng/ml_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1078-1439(12)00229-3 DB - PRIME DP - Unbound Medicine ER -