PURPOSE: Short prostate specific antigen doubling time following recurrence after radical prostatectomy portends a poor prognosis in men with prostate cancer. We determined which demographic and clinicopathological variables were predictive of a short prostate specific antigen doubling time in a cohort of men with clinically localized prostate cancer treated with radical prostatectomy. MATERIALS AND METHODS: Data on 856 men from the Shared Equal Access Regional Cancer Hospital database who underwent radical prostatectomy for node negative prostate cancer between 1988 and 2003 were included in the analysis. We used logistic regression analysis to determine the independent factors associated with a short prostate specific antigen doubling time of less than 9 months vs a longer doubling time of 9 months or greater, or no recurrence. The variables analyzed were patient age, race, logarithmically transformed preoperative prostate specific antigen, body mass index, year of surgery, pathological Gleason sum, extraprostatic extension, surgical margin status and seminal vesicle invasion. RESULTS: On multivariate analysis higher preoperative prostate specific antigen (OR 2.20, 95% CI 1.52-3.19, p <0.001), pathological Gleason sum 8-10 (OR 4.70, 95% CI 2.11-10.43, p <0.001) and 7 (OR 2.11, 95% CI 1.09-4.08, p = 0.026), tumors with extraprostatic extension and/or positive surgical margins (OR 2.08, 95% CI 1.48-3.91, p = 0.023), and seminal vesicle invasion (OR 3.26, 95% CI 1.48-7.21, p = 0.003) were independent predictors of a short prostate specific antigen doubling time. Based on these risk factors we developed a table to estimate the risk of recurrence with a prostate specific antigen doubling time of less than 9 months. CONCLUSIONS: The factors that are invariably used to predict overall biochemical recurrence following radical prostatectomy, including high prostate specific antigen, high grade and adverse pathological findings, also predict aggressive recurrence.
PURPOSE: Short prostate specific antigen doubling time following recurrence after radical prostatectomy portends a poor prognosis in men with prostate cancer. We determined which demographic and clinicopathological variables were predictive of a short prostate specific antigen doubling time in a cohort of men with clinically localized prostate cancer treated with radical prostatectomy. MATERIALS AND METHODS: Data on 856 men from the Shared Equal Access Regional Cancer Hospital database who underwent radical prostatectomy for node negative prostate cancer between 1988 and 2003 were included in the analysis. We used logistic regression analysis to determine the independent factors associated with a short prostate specific antigen doubling time of less than 9 months vs a longer doubling time of 9 months or greater, or no recurrence. The variables analyzed were patient age, race, logarithmically transformed preoperative prostate specific antigen, body mass index, year of surgery, pathological Gleason sum, extraprostatic extension, surgical margin status and seminal vesicle invasion. RESULTS: On multivariate analysis higher preoperative prostate specific antigen (OR 2.20, 95% CI 1.52-3.19, p <0.001), pathological Gleason sum 8-10 (OR 4.70, 95% CI 2.11-10.43, p <0.001) and 7 (OR 2.11, 95% CI 1.09-4.08, p = 0.026), tumors with extraprostatic extension and/or positive surgical margins (OR 2.08, 95% CI 1.48-3.91, p = 0.023), and seminal vesicle invasion (OR 3.26, 95% CI 1.48-7.21, p = 0.003) were independent predictors of a short prostate specific antigen doubling time. Based on these risk factors we developed a table to estimate the risk of recurrence with a prostate specific antigen doubling time of less than 9 months. CONCLUSIONS: The factors that are invariably used to predict overall biochemical recurrence following radical prostatectomy, including high prostate specific antigen, high grade and adverse pathological findings, also predict aggressive recurrence.
Authors: Stephen J Freedland; Christopher L Amling; Frederick Dorey; Christopher J Kane; Joseph C Presti; Martha K Terris; William J Aronson Journal: Urology Date: 2002-10 Impact factor: 2.649
Authors: Darlene D Lin; Delray Schultz; Andrew A Renshaw; Mark A Rubin; Jerome P Richie; Anthony V D'Amico Journal: Urology Date: 2005-03 Impact factor: 2.649
Authors: Stephen J Freedland; WilliamJ Aronson; Joseph C Presti; Christopher J Kane; Martha K Terris; David Elashoff; Christopher L Amling Journal: J Urol Date: 2003-06 Impact factor: 7.450
Authors: A V D'Amico; R Whittington; S B Malkowicz; D Schultz; K Blank; G A Broderick; J E Tomaszewski; A A Renshaw; I Kaplan; C J Beard; A Wein Journal: JAMA Date: 1998-09-16 Impact factor: 56.272
Authors: Anthony V D'Amico; Judd W Moul; Peter R Carroll; Leon Sun; Deborah Lubeck; Ming-Hui Chen Journal: J Natl Cancer Inst Date: 2003-09-17 Impact factor: 13.506
Authors: Roberto L Muller; Joseph C Presti; William J Aronson; Martha K Terris; Christopher J Kane; Christopher L Amling; Stephen J Freedland Journal: Urology Date: 2012-03-23 Impact factor: 2.649
Authors: Anna E Teeter; Joseph C Presti; William J Aronson; Martha K Terris; Christopher J Kane; Christopher L Amling; Stephen J Freedland Journal: Urology Date: 2013-07 Impact factor: 2.649
Authors: Anna E Teeter; Joseph C Presti; William J Aronson; Martha K Terris; Christopher J Kane; Christopher L Amling; Stephen J Freedland Journal: Urology Date: 2010-12-08 Impact factor: 2.649
Authors: Florian R Schroeck; William J Aronson; Joseph C Presti; Martha K Terris; Christopher J Kane; Christopher L Amling; Stephen J Freedland Journal: BJU Int Date: 2008-11-18 Impact factor: 5.588
Authors: Ohseong Kwon; Ki Bom Kim; Young Ik Lee; Seok-Soo Byun; Jae-Sung Kim; Sang Eun Lee; Sung Kyu Hong Journal: PLoS One Date: 2014-07-29 Impact factor: 3.240