Stephanie L Skove1, Lauren E Howard2, William J Aronson3, Martha K Terris4, Christopher J Kane5, Christopher L Amling6, Matthew R Cooperberg7, Daniel M Moreira8, Stephen J Freedland9. 1. Urology Section, Department of Surgery, Veterans Affairs Medical Center, Durham, NC. 2. Urology Section, Department of Surgery, Veterans Affairs Medical Center, Durham, NC; Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC. 3. Urology Section, Department of Surgery, Veterans Affairs Medical Center, Greater Los Angeles, Los Angeles, CA; Department of Urology, University of California at Los Angeles Medical Center, Los Angeles, CA. 4. Urology Section, Division of Surgery, Veterans Affairs Medical Centers and Division of Urologic Surgery, Department of Surgery, Medical College of Georgia, Augusta, GA. 5. Department of Urology, University of California at San Diego Medical Center, San Diego, CA. 6. Department of Urology, Oregon Health & Science University, Portland, OR. 7. Departments of Urology and Epidemiology & Biostatistics, University of California, San Francisco, CA; Urology Section, Department of Surgery, Veterans Affairs Medical Center, San Francisco, CA. 8. Department of Urology, University of Illinois at Chicago, Chicago, IL. 9. Urology Section, Department of Surgery, Veterans Affairs Medical Center, Durham, NC; Department of Surgery, Division of Urology and Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA; Center for Integrated Research in Cancer and Lifestyle, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA. Electronic address: Stephen.freedland@cshs.org.
Abstract
OBJECTIVE: To evaluate the association between the prostate-specific antigen (PSA) nadir level and the time to nadir (TTN) with biochemical recurrence (BCR) risk after radical prostatectomy (RP) in the Shared Equal-Access Research Cancer Hospital (SEARCH) database. MATERIALS AND METHODS: This is a retrospective analysis of 1939 men from the SEARCH database treated with RP between 1998 and 2015 with available ultrasensitive PSA nadir within 1-6 months after RP. Uni- and multivariable analyses of PSA nadir and TTN with time from nadir to BCR were performed with Cox models (adjusted for demographics, tumor features, and preoperative PSA). RESULTS: Among men with an undetectable PSA nadir, the TTN was unrelated to BCR (1.0-2.9 vs 3-6 months: hazard ratio [HR] 0.86, P = .46). Regardless of TTN, men with detectable nadir had an increased risk of BCR (TTN of 3-6 months: HR 1.81, P = .024; TTN of 1.0-2.99 months: HR 3.75, P <.001 vs undetectable nadir and TTN of 3-6 months). Among men with a detectable PSA at 1-3 months, 53% had a lower PSA level during follow-up 3-6 months after RP, which was undetectable in 32% and lower but still detectable in 21%. CONCLUSION: In the post-RP setting, men with both a detectable nadir and a shorter TTN had an increased risk of BCR. Intriguingly, about half of the men with a detectable PSA in the first 3 months after RP had a lower PSA level during follow-up between 3 and 6 months after RP. If confirmed in future studies, this has important implications for patients considering adjuvant therapy based on postoperative PSA values in the first 3 months after RP.
OBJECTIVE: To evaluate the association between the prostate-specific antigen (PSA)nadir level and the time to nadir (TTN) with biochemical recurrence (BCR) risk after radical prostatectomy (RP) in the Shared Equal-Access Research Cancer Hospital (SEARCH) database. MATERIALS AND METHODS: This is a retrospective analysis of 1939 men from the SEARCH database treated with RP between 1998 and 2015 with available ultrasensitive PSAnadir within 1-6 months after RP. Uni- and multivariable analyses of PSAnadir and TTN with time from nadir to BCR were performed with Cox models (adjusted for demographics, tumor features, and preoperative PSA). RESULTS: Among men with an undetectable PSAnadir, the TTN was unrelated to BCR (1.0-2.9 vs 3-6 months: hazard ratio [HR] 0.86, P = .46). Regardless of TTN, men with detectable nadir had an increased risk of BCR (TTN of 3-6 months: HR 1.81, P = .024; TTN of 1.0-2.99 months: HR 3.75, P <.001 vs undetectable nadir and TTN of 3-6 months). Among men with a detectable PSA at 1-3 months, 53% had a lower PSA level during follow-up 3-6 months after RP, which was undetectable in 32% and lower but still detectable in 21%. CONCLUSION: In the post-RP setting, men with both a detectable nadir and a shorter TTN had an increased risk of BCR. Intriguingly, about half of the men with a detectable PSA in the first 3 months after RP had a lower PSA level during follow-up between 3 and 6 months after RP. If confirmed in future studies, this has important implications for patients considering adjuvant therapy based on postoperative PSA values in the first 3 months after RP.
Authors: H Wadhwa; M K Terris; W J Aronson; C J Kane; C L Amling; M R Cooperberg; S J Freedland; M R Abern Journal: Prostate Cancer Prostatic Dis Date: 2016-10-04 Impact factor: 5.554
Authors: Stephen J Freedland; Elizabeth B Humphreys; Leslie A Mangold; Mario Eisenberger; Frederick J Dorey; Patrick C Walsh; Alan W Partin Journal: JAMA Date: 2005-07-27 Impact factor: 56.272
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Authors: Daniela A Ferraro; Helena I Garcia Schüler; Urs J Muehlematter; Daniel Eberli; Julian Müller; Alexander Müller; Roger Gablinger; Helmut Kranzbühler; Aurelius Omlin; Philipp A Kaufmann; Thomas Hermanns; Irene A Burger Journal: Eur J Nucl Med Mol Imaging Date: 2019-12-04 Impact factor: 9.236
Authors: Ahmed S Zakaria; Russell N Schwartz; Amr Hodhod; Félix Couture; Côme Tholomier; Hanna Shahine; Cristina Negrean; David-Dan Nguyen; Marc Zanaty; Franziska Stolzenbach; Pierre I Karakiewicz; Assaad El-Hakim; Kevin C Zorn Journal: World J Urol Date: 2020-07-21 Impact factor: 4.226