Usefulness of ultrasensitive prostate-specific antigen assay for early detection of biochemical failure after radical prostatectomy.
BACKGROUND
In order to assess whether the prostate-specific antigen (PSA) nadir obtained with an ultrasensitive PSA assay can be used as a prognostic indicator for patients undergoing radical prostatectomy, we investigated it retrospectively.


METHODS
Between October 1997 and July 2003, 46 patients underwent radical prostatectomy for prostate cancer at our institution. None of them received preoperative treatment. Levels of PSA were measured with an ultrasensitive PSA assay every 1-3 months after prostatectomy. Biochemical recurrence was defined as a PSA level of 0.2 ng/mL or higher.


RESULTS
There was a significant difference in PSA nadir between the biochemical recurrence group and the no recurrence group (P < 0.001). The receiver operating characteristics (ROC) curve gave an optimal cut-off value for PSA nadir of 0.01 ng/mL, demonstrating a significant difference in biochemical recurrence after radical prostatectomy. No patient with a PSA nadir level <0.01 ng/mL showed biochemical failure, while 15 out of 22 patients with PSA nadir levels >or=0.01 ng/mL showed biochemical failure.


CONCLUSIONS
The PSA nadir level obtained using an ultrasensitive PSA assay is an excellent predictor of biochemical recurrence after radical prostatectomy. Early detection of recurrence offers the possibility of early salvage therapy.
Nakamura
Masafumi
M
Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Hasumi
Hisashi
H
Miyoshi
Yasuhide
Y
Sugiura
Shinpei
S
Fujinami
Kiyoshi
K
Yao
Masahiro
M
Kubota
Yoshinobu
Y
Uemura
Hiroji
H
D000368:Aged; D042241:Early Diagnosis; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000097:blood; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood* / Q000601:surgery*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D017211:Treatment Failure
D017430:Prostate-Specific Antigen