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Prognostic impact of time to undetectable prostate-specific antigen in patients with positive surgical margins following radical prostatectomy

Authors
 Kyo Chul Koo  ;  Patrick Tuliao  ;  Christos Komninos  ;  Young Deuk Choi  ;  Byung Ha Chung  ;  Sung Joon Hong  ;  Sun Ha Jee  ;  Koon Ho Rha 
Citation
 Annals of Surgical Oncology, Vol.22(2) : 693-700, 2015 
Journal Title
 Annals of Surgical Oncology 
ISSN
 1068-9265 
Issue Date
2015
Abstract
BACKGROUND: The purpose of this article was to determine the impact of time to undetectable prostate-specific antigen (PSA) for predicting biochemical recurrence (BCR) in patients with a positive surgical margin (PSM) following radical prostatectomy (RP). A PSM is an independent predictor of BCR; however, not all patients develop BCR later on. METHODS: A retrospective analysis was conducted on 1,117 consecutive prostate cancer patients who underwent RP without neoadjuvant or adjuvant therapy from July 2005 to December 2009. Of these, 516 (46.2 %) patients without PSMs, and 214 (19.2 %) patients with PSMs who later achieved undetectable PSA, defined as <0.01 ng/ml, were identified. Patients with PSMs were stratified according to time to undetectable PSA dichotomized at 6 weeks and compared with patients without PSMs. Patients with PSMs who did not achieve undetectable PSA were excluded. BCR was defined as two consecutive increases of post-undetectable PSA ≥0.2 ng/ml. RESULTS: During the median follow-up of 58.2 months, patients with PSMs who achieved undetectable PSA in <6 weeks had comparable 5-year BCR-free survival rates to those without PSMs; however, patients with PSMs who achieved undetectable PSA in ≥6 weeks showed significantly lower rates compared with both patients without PSMs (59.2 vs 74.3 %; p < 0.001) and patients with PSMs who achieved undetectable PSA in <6 weeks (59.2 vs 78.8 %; p = 0.004). Among patients with PSMs, multivariate analysis revealed time to undetectable PSA at ≥6 weeks and seminal vesicle invasion to be independent predictors of BCR. No perioperative factors were associated with undetectable PSA at ≥6 weeks. CONCLUSIONS: Patients with PSMs who achieve undetectable PSA in <6 weeks show comparable risks of BCR to patients with negative surgical margins.
Full Text
http://link.springer.com/article/10.1245%2Fs10434-014-4057-z
DOI
10.1245/s10434-014-4057-z
Appears in Collections:
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
구교철(Koo, Kyo Chul) ORCID logo https://orcid.org/0000-0001-7303-6256
나군호(Rha, Koon Ho) ORCID logo https://orcid.org/0000-0001-8588-7584
정병하(Chung, Byung Ha) ORCID logo https://orcid.org/0000-0001-9817-3660
지선하(Jee, Sun Ha) ORCID logo https://orcid.org/0000-0001-9519-3068
최영득(Choi, Young Deuk) ORCID logo https://orcid.org/0000-0002-8545-5797
크리스토스콤니노스(Komninos, Christos)
툴리아오패트릭(Tuliao, Patrick)
홍성준(Hong, Sung Joon) ORCID logo https://orcid.org/0000-0001-9869-065X
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/139271
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