PURPOSE: Among patients with biochemical recurrence after radical prostatectomy, we found previously that postoperative prostate-specific antigen doubling time (PSADT) was associated with risk of prostate cancer death. However, given the small number of patients in the highest risk PSADT subgroup, it is unclear which PSADT subgroups contribute the greatest to prostate cancer-specific death and how this influences all-cause mortality. PATIENTS AND METHODS: This study was a retrospective analysis of 379 patients treated with radical prostatectomy between 1982 and 2000 who had a biochemical recurrence and PSADT data available. Mean and median follow-up after surgery was 11.4 (standard deviation, 5.4) and 11.0 years, respectively (range, 1.6 to 23.0 years). RESULTS: Shorter PSADT was significantly associated with prostate cancer-specific and all-cause mortality (P < .001). Although patients with a PSADT less than 3 months were at the greatest risk of death, because of the limited number of patients in this group, they accounted for only 13% of prostate cancer deaths at 15 years after biochemical recurrence, whereas patients with an intermediate PSADT (3.0 to 8.9 months) accounted for 58% of all prostate cancer deaths. Among patients with a PSADT less than 15 months, prostate cancer accounted for 90% of all deaths. Only patients in the slowest PSADT subgroup (> or = 15 months) had a greater risk of competing-causes mortality compared with that from prostate cancer. CONCLUSION: Among a select cohort of young, healthy patients with PSA recurrence after radical prostatectomy and a PSADT less than 15 months, prostate cancer accounted for an estimated 90% of all deaths by 15 years after recurrence. The majority of prostate cancer deaths occurred among patients with an intermediate PSADT (3.0 to 8.9 months).
PURPOSE: Among patients with biochemical recurrence after radical prostatectomy, we found previously that postoperative prostate-specific antigen doubling time (PSADT) was associated with risk of prostate cancer death. However, given the small number of patients in the highest risk PSADT subgroup, it is unclear which PSADT subgroups contribute the greatest to prostate cancer-specific death and how this influences all-cause mortality. PATIENTS AND METHODS: This study was a retrospective analysis of 379 patients treated with radical prostatectomy between 1982 and 2000 who had a biochemical recurrence and PSADT data available. Mean and median follow-up after surgery was 11.4 (standard deviation, 5.4) and 11.0 years, respectively (range, 1.6 to 23.0 years). RESULTS: Shorter PSADT was significantly associated with prostate cancer-specific and all-cause mortality (P < .001). Although patients with a PSADT less than 3 months were at the greatest risk of death, because of the limited number of patients in this group, they accounted for only 13% of prostate cancer deaths at 15 years after biochemical recurrence, whereas patients with an intermediate PSADT (3.0 to 8.9 months) accounted for 58% of all prostate cancer deaths. Among patients with a PSADT less than 15 months, prostate cancer accounted for 90% of all deaths. Only patients in the slowest PSADT subgroup (> or = 15 months) had a greater risk of competing-causes mortality compared with that from prostate cancer. CONCLUSION: Among a select cohort of young, healthy patients with PSA recurrence after radical prostatectomy and a PSADT less than 15 months, prostate cancer accounted for an estimated 90% of all deaths by 15 years after recurrence. The majority of prostate cancer deaths occurred among patients with an intermediate PSADT (3.0 to 8.9 months).
Authors: Wanling Xie; Meredith M Regan; Marc Buyse; Susan Halabi; Philip W Kantoff; Oliver Sartor; Howard Soule; Donald Berry; Noel Clarke; Laurence Collette; Anthony D'Amico; Richard De Abreu Lourenco; James Dignam; Mario Eisenberger; Nicholas James; Karim Fizazi; Silke Gillessen; Yohann Loriot; Nicolas Mottet; Wendy Parulekar; Howard Sandler; Daniel E Spratt; Matthew R Sydes; Bertrand Tombal; Scott Williams; Christopher J Sweeney Journal: J Clin Oncol Date: 2020-06-18 Impact factor: 44.544
Authors: Emmanuel S Antonarakis; Yongmei Chen; Sally I Elsamanoudi; Stephen A Brassell; Mario V Da Rocha; Mario A Eisenberger; David G McLeod Journal: BJU Int Date: 2010-11-23 Impact factor: 5.588
Authors: E David Crawford; Robert Grubb; Amanda Black; Gerald L Andriole; Ming-Hui Chen; Grant Izmirlian; Christine D Berg; Anthony V D'Amico Journal: J Clin Oncol Date: 2010-11-01 Impact factor: 44.544
Authors: Anna E Teeter; Lionel L Bañez; Joseph C Presti; William J Aronson; Martha K Terris; Christopher J Kane; Christopher L Amling; Stephen J Freedland Journal: J Urol Date: 2008-09-17 Impact factor: 7.450
Authors: Mariana Andozia Morini; Roberto Lodeiro Muller; Paulo César Barbosa de Castro Junior; Rafael José de Souza; Eliney Ferreira Faria Journal: World J Urol Date: 2018-03-16 Impact factor: 4.226
Authors: Lauren V Wood; Antonio Fojo; Brenda D Roberson; Meghan S B Hughes; William Dahut; James L Gulley; Ravi A Madan; Philip M Arlen; Marianna Sabatino; David F Stroncek; Luciano Castiello; Jane B Trepel; Min-Jung Lee; Howard L Parnes; Seth M Steinberg; Masaki Terabe; Julia Wilkerson; Ira Pastan; Jay A Berzofsky Journal: Oncoimmunology Date: 2016-07-01 Impact factor: 8.110
Authors: Robert J Hamilton; William J Aronson; Martha K Terris; Christopher J Kane; Joseph C Presti; Christopher L Amling; Stephen J Freedland Journal: J Urol Date: 2008-03-17 Impact factor: 7.450