title: Clearance of serum PSA after open surgery for benign prostatic hypertrophy, radical cystectomy, and radical prostatectomy.
abstract: OBJECTIVE
  To study the clearance of serum prostate-specific antigen (PSA) after several types of prostatic tissue ablation.
  
  
  METHODS
  Serum PSA levels were measured (YANG Proscheck ultrasensitive assay) just before surgery, immediately after specimen removal, then twice weekly for 5 weeks or until it was undetectable (< 0.05 ng/ml) in patients undergoing radical cystoprostatectomy for bladder cancer (n = 10), or radical prostatectomy for T1 T2 prostate cancer (n = 18) and daily for 6 days after open surgery for benign prostatic hypertrophy (BPH) (n = 10).
  
  
  RESULTS
  Open enucleation for BPH: the immediately postoperative PSA level was 6 times its preoperative value. It decreased following a monoexponential curve with a very short half-life of 0.55 +/- 0.39 days, range (0.14-1.3), reaching a value lower than the preoperative level in all cases, except one by day 3. After radical cystoprostatectomy: the decrease of serum PSA is monoexponential with a half life of 1.92 +/- 1.2 days (0.57-4.24) reaching undetectable level (< 0.05 ng/ml) in all patients by day 21. After radical prostatectomy: 11/18 patients (61%) showed a one-component exponential decrease in PSA with a half-life of 2.5 +/- 1.33 days (range 0.97-4.6 days), and 7/18 showed a two-component exponential decrease with a first half-life of 0.94 +/- 0.8 days and a second of 7.62 +/- 6.35 days); 100% of the patients reached undetectable serum PSA by day 28 in the first group compared to 14.2% of the patients with a two component exponential decrease (P < 0.01). There was no difference between these groups as far as preoperative PSA levels and specimen pathology were concerned.
  
  
  CONCLUSIONS
  Serum clearance of PSA after extirpative prostatic surgery is closely related to the type and indication of procedure used. Radical cystoprostatectomy is probably the best model in which to study the pharmacokinetics of PSA.
authors.affiliation: Department of Urology, Hôpital Bichat, Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Haab
authors.forename: A
authors.initials: A
authors.lastname: Meulemans
authors.forename: L
authors.initials: L
authors.lastname: Boccon-Gibod
authors.forename: M C
authors.initials: MC
authors.lastname: Dauge
authors.forename: V
authors.initials: V
authors.lastname: Delmas
authors.forename: L
authors.initials: L
authors.lastname: Boccon-Gibod
mesh_terms: D015653:Cystectomy / Q000379:methods; D006801:Humans; D008297:Male; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy / Q000379:methods; D011470:Prostatic Hyperplasia / Q000276:immunology* / Q000601:surgery*
chemical_list: D017430:Prostate-Specific Antigen