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Prediction of biochemical failure using prostate-specific antigen half-life in patients with adverse pathologic features after radical prostatectomy

 Kwang Suk Lee  ;  Kyo Chul Koo  ;  Byung Ha Chung 
 World Journal of Urology, Vol.37(7) : 1321-1328, 2019 
Journal Title
 World Journal of Urology 
Issue Date
Patient outcome assessment ; Prostate ; Prostate cancer ; Prostatectomy
PURPOSE: Prostate-specific antigen nadir and time to prostate-specific antigen nadir are predictors of disease progression in patients who undergo radical prostatectomy. However, a mutually conflicting relationship exists between them. Thus, we compared postoperative prostate-specific antigen levels at the first follow-up with the expected levels while considering the half-life of prostate-specific antigen to improve the prediction of biochemical failure after radical prostatectomy in patients with adverse pathologic features. METHODS: Patients treated with robot-assisted laparoscopic prostatectomy were enrolled. Patients with a follow-up duration of < 12 months or positive lymphadenectomy results were excluded. "Adverse prostate-specific antigen" was defined as a prostate-specific antigen level higher than the expected level at 6 weeks. RESULTS: Among 450 patients, adverse pathologic features and adverse prostate-specific antigen were found in 260 (57.8%) and 245 (54.5%) patients, respectively. Analysis of patients with and without abnormal prostate-specific antigen level revealed significantly different biochemical failure-free survival outcomes. Patients with one adverse pathologic feature but without adverse prostate-specific antigen showed similar biochemical failure-free survival to those without adverse pathologic features. Adverse prostate-specific antigen was identified as an independent predictor for biochemical failure within 1 year after radical prostatectomy. The area under the curve when adding adverse prostate-specific antigen to the conventional factors was significantly higher than that for the conventional factors alone. CONCLUSION: The difference between postoperative prostate-specific antigen levels at the first follow-up visit after radical prostatectomy and the expected level while considering the half-life of prostate-specific antigen is a predictive factor for treatment efficacy following radical prostatectomy.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Koo, Kyo Chul(구교철) ORCID logo https://orcid.org/0000-0001-7303-6256
Lee, Kwang Suk(이광석) ORCID logo https://orcid.org/0000-0002-7961-8393
Chung, Byung Ha(정병하) ORCID logo https://orcid.org/0000-0001-9817-3660
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