Cargando…

The Impact of the Percent of Residual Prostate-Specific Antigen on Metastasis-Free Survival in Patients with Persistent Prostate-Specific Antigen after Radical Prostatectomy

PURPOSE: Persistent levels of prostate-specific antigen (PSA) is a poor prognostic factor for recurrence after radical prostatectomy (RP). We investigated the impact of the percentage of residual PSA (%rPSA) [(post-/preoperative PSA)×100], representing a biochemical residual tumor, and the first pos...

Descripción completa

Detalles Bibliográficos
Autores principales: Lee, Dan Bee, Kim, Jae Yeon, Song, Won Hoon, Nam, Jong Kil, Lee, Hyun Jung, Kim, Tae Un, Park, Sung-Woo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society for Sexual Medicine and Andrology 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9826909/
https://www.ncbi.nlm.nih.gov/pubmed/36047076
http://dx.doi.org/10.5534/wjmh.220066
_version_ 1784866960308174848
author Lee, Dan Bee
Kim, Jae Yeon
Song, Won Hoon
Nam, Jong Kil
Lee, Hyun Jung
Kim, Tae Un
Park, Sung-Woo
author_facet Lee, Dan Bee
Kim, Jae Yeon
Song, Won Hoon
Nam, Jong Kil
Lee, Hyun Jung
Kim, Tae Un
Park, Sung-Woo
author_sort Lee, Dan Bee
collection PubMed
description PURPOSE: Persistent levels of prostate-specific antigen (PSA) is a poor prognostic factor for recurrence after radical prostatectomy (RP). We investigated the impact of the percentage of residual PSA (%rPSA) [(post-/preoperative PSA)×100], representing a biochemical residual tumor, and the first postoperative PSA (fPSA) level on metastasis-free survival (MFS) in men with persistent levels of PSA after RP. MATERIALS AND METHODS: We retrospectively identified male patients within a single tertiary referral hospital database who harbored persistent (≥0.1 ng/mL) vs. undetectable (<0.1 ng/mL) PSA levels 4 to 8 weeks after RP. Kaplan–Meier analyses and Cox regression models were used to test the effect of persistent PSA levels, the fPSA level, and %rPSA on MFS. RESULTS: Of 1,205 patients, 178 patients with persistent PSA levels were enrolled. Seven-year MFS rates were 60.5% vs. 84.3% (p<0.001) for patients with a %rPSA ≥6% and <6%, respectively. Multivariable Cox regression models of the overall cohort revealed that persistent PSA levels (hazard ratio [HR], 3.94; p=0.010), extracapsular extension (HR, 4.17; 95% confidence interval [CI], 1.06–16.41; p=0.041), and pathological Gleason grade group (pGGG) (HR, 3.69; 95% CI, 1.32–10.27; p=0.013) were independent predictors of metastasis. Multivariable Cox regression models in men with persistent PSA levels revealed that the %rPSA (HR, 8.92; 95% CI, 1.74–45.71; p=0.009) and pGGG 4–5 (HR, 4.13; 95% CI, 1.22–13.96; p=0.022) were independent predictors of distant metastasis, but not the fPSA level after surgery. CONCLUSIONS: Persistent levels of PSA were associated with worse MFS after RP. In men with persistent PSA levels after RP, the %rPSA is a valuable predictor of MFS unlike the fPSA level.
format Online
Article
Text
id pubmed-9826909
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Korean Society for Sexual Medicine and Andrology
record_format MEDLINE/PubMed
spelling pubmed-98269092023-01-19 The Impact of the Percent of Residual Prostate-Specific Antigen on Metastasis-Free Survival in Patients with Persistent Prostate-Specific Antigen after Radical Prostatectomy Lee, Dan Bee Kim, Jae Yeon Song, Won Hoon Nam, Jong Kil Lee, Hyun Jung Kim, Tae Un Park, Sung-Woo World J Mens Health Original Article PURPOSE: Persistent levels of prostate-specific antigen (PSA) is a poor prognostic factor for recurrence after radical prostatectomy (RP). We investigated the impact of the percentage of residual PSA (%rPSA) [(post-/preoperative PSA)×100], representing a biochemical residual tumor, and the first postoperative PSA (fPSA) level on metastasis-free survival (MFS) in men with persistent levels of PSA after RP. MATERIALS AND METHODS: We retrospectively identified male patients within a single tertiary referral hospital database who harbored persistent (≥0.1 ng/mL) vs. undetectable (<0.1 ng/mL) PSA levels 4 to 8 weeks after RP. Kaplan–Meier analyses and Cox regression models were used to test the effect of persistent PSA levels, the fPSA level, and %rPSA on MFS. RESULTS: Of 1,205 patients, 178 patients with persistent PSA levels were enrolled. Seven-year MFS rates were 60.5% vs. 84.3% (p<0.001) for patients with a %rPSA ≥6% and <6%, respectively. Multivariable Cox regression models of the overall cohort revealed that persistent PSA levels (hazard ratio [HR], 3.94; p=0.010), extracapsular extension (HR, 4.17; 95% confidence interval [CI], 1.06–16.41; p=0.041), and pathological Gleason grade group (pGGG) (HR, 3.69; 95% CI, 1.32–10.27; p=0.013) were independent predictors of metastasis. Multivariable Cox regression models in men with persistent PSA levels revealed that the %rPSA (HR, 8.92; 95% CI, 1.74–45.71; p=0.009) and pGGG 4–5 (HR, 4.13; 95% CI, 1.22–13.96; p=0.022) were independent predictors of distant metastasis, but not the fPSA level after surgery. CONCLUSIONS: Persistent levels of PSA were associated with worse MFS after RP. In men with persistent PSA levels after RP, the %rPSA is a valuable predictor of MFS unlike the fPSA level. Korean Society for Sexual Medicine and Andrology 2023-01 2022-08-16 /pmc/articles/PMC9826909/ /pubmed/36047076 http://dx.doi.org/10.5534/wjmh.220066 Text en Copyright © 2023 Korean Society for Sexual Medicine and Andrology https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Lee, Dan Bee
Kim, Jae Yeon
Song, Won Hoon
Nam, Jong Kil
Lee, Hyun Jung
Kim, Tae Un
Park, Sung-Woo
The Impact of the Percent of Residual Prostate-Specific Antigen on Metastasis-Free Survival in Patients with Persistent Prostate-Specific Antigen after Radical Prostatectomy
title The Impact of the Percent of Residual Prostate-Specific Antigen on Metastasis-Free Survival in Patients with Persistent Prostate-Specific Antigen after Radical Prostatectomy
title_full The Impact of the Percent of Residual Prostate-Specific Antigen on Metastasis-Free Survival in Patients with Persistent Prostate-Specific Antigen after Radical Prostatectomy
title_fullStr The Impact of the Percent of Residual Prostate-Specific Antigen on Metastasis-Free Survival in Patients with Persistent Prostate-Specific Antigen after Radical Prostatectomy
title_full_unstemmed The Impact of the Percent of Residual Prostate-Specific Antigen on Metastasis-Free Survival in Patients with Persistent Prostate-Specific Antigen after Radical Prostatectomy
title_short The Impact of the Percent of Residual Prostate-Specific Antigen on Metastasis-Free Survival in Patients with Persistent Prostate-Specific Antigen after Radical Prostatectomy
title_sort impact of the percent of residual prostate-specific antigen on metastasis-free survival in patients with persistent prostate-specific antigen after radical prostatectomy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9826909/
https://www.ncbi.nlm.nih.gov/pubmed/36047076
http://dx.doi.org/10.5534/wjmh.220066
work_keys_str_mv AT leedanbee theimpactofthepercentofresidualprostatespecificantigenonmetastasisfreesurvivalinpatientswithpersistentprostatespecificantigenafterradicalprostatectomy
AT kimjaeyeon theimpactofthepercentofresidualprostatespecificantigenonmetastasisfreesurvivalinpatientswithpersistentprostatespecificantigenafterradicalprostatectomy
AT songwonhoon theimpactofthepercentofresidualprostatespecificantigenonmetastasisfreesurvivalinpatientswithpersistentprostatespecificantigenafterradicalprostatectomy
AT namjongkil theimpactofthepercentofresidualprostatespecificantigenonmetastasisfreesurvivalinpatientswithpersistentprostatespecificantigenafterradicalprostatectomy
AT leehyunjung theimpactofthepercentofresidualprostatespecificantigenonmetastasisfreesurvivalinpatientswithpersistentprostatespecificantigenafterradicalprostatectomy
AT kimtaeun theimpactofthepercentofresidualprostatespecificantigenonmetastasisfreesurvivalinpatientswithpersistentprostatespecificantigenafterradicalprostatectomy
AT parksungwoo theimpactofthepercentofresidualprostatespecificantigenonmetastasisfreesurvivalinpatientswithpersistentprostatespecificantigenafterradicalprostatectomy
AT leedanbee impactofthepercentofresidualprostatespecificantigenonmetastasisfreesurvivalinpatientswithpersistentprostatespecificantigenafterradicalprostatectomy
AT kimjaeyeon impactofthepercentofresidualprostatespecificantigenonmetastasisfreesurvivalinpatientswithpersistentprostatespecificantigenafterradicalprostatectomy
AT songwonhoon impactofthepercentofresidualprostatespecificantigenonmetastasisfreesurvivalinpatientswithpersistentprostatespecificantigenafterradicalprostatectomy
AT namjongkil impactofthepercentofresidualprostatespecificantigenonmetastasisfreesurvivalinpatientswithpersistentprostatespecificantigenafterradicalprostatectomy
AT leehyunjung impactofthepercentofresidualprostatespecificantigenonmetastasisfreesurvivalinpatientswithpersistentprostatespecificantigenafterradicalprostatectomy
AT kimtaeun impactofthepercentofresidualprostatespecificantigenonmetastasisfreesurvivalinpatientswithpersistentprostatespecificantigenafterradicalprostatectomy
AT parksungwoo impactofthepercentofresidualprostatespecificantigenonmetastasisfreesurvivalinpatientswithpersistentprostatespecificantigenafterradicalprostatectomy