Predicting prostate specific antigen failure after radical retropubic prostatectomy for T1c prostate cancer.
OBJECTIVE
Clinicopathological data were reviewed to find a predictor of prostate specific antigen (PSA) failure in Taiwanese patients who had received radical retropubic prostatectomy (RRP) for stage T1c prostate cancer (PC).


METHODS
Fifty-five consecutive men who underwent RRP for stage T1c PC were included. The clinical end point was PSA failure (PSA >0.2 ng/ml). Preoperative PSA, free-to-total PSA ratio, prostate volume, PSA density, transrectal sextant biopsy and whole mount of RRP parameters were analyzed for their ability to predict postoperative PSA failure.


RESULTS
Fifteen of the 55 patients developed PSA failure during the follow-up period. Those with PSA failure had higher PSA, higher percentage of cancer in biopsies and higher biopsy Gleason score than the freedom from PSA failure group (all P < 0.05). The PSA failure group had higher pathology Gleason score and a higher incidence of extracapsular tumor extension than the freedom from PSA failure group (all P < 0.05). The PSA failure group had a larger tumor volume and higher incidence of combined peripheral lobe with transitional lobe involvement than the freedom from PSA failure group (all P < 0.05). Multivariate analysis revealed that the predictors for PSA failure after RRP were biopsy Gleason score > or =6, tumor volume > or =2.5 ml and PSA > or =10 ng/ml.


CONCLUSIONS
The single most significant predictor for PSA failure in T1c PC patients after RRP was tumor volume > or =2.5 ml.
Ou
Yen-Chuan
YC
Division of Urology, Department of Surgery, Taichung Veterans General Hospital, National Yang-Ming University School of Medicine, Taiwan.
Chen
Jung-Ta
JT
Yang
Chi-Rei
CR
Cheng
Chen-Li
CL
Ho
Hao-Chung
HC
Ko
Jiunn-Liang
JL
Hsieh
Yih-Shou
YS
D014408:Biomarkers, Tumor / Q000097:blood*; D001706:Biopsy; D005544:Forecasting; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate
D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen