title: Prostate-specific antigen failure within 2 years of radical prostatectomy predicts overall survival.
abstract: OBJECTIVE
  This study attempts to determine whether prostate-specific antigen (PSA) failure following radical retropubic prostatectomy (RRP) affects patients' long-term overall survival.
  
  
  METHODS
  This study examined 155 men diagnosed as clinical stages T1b-T3a who received RRP as primary therapy. To evaluate whether PSA failure following RRP affects overall survival, the patients were grouped into those who experienced PSA failure within 2 years and those who did not. Clinical failure-free survival, prostate cancer-specific survival and overall survival were used as endpoints. Comparisons of survival curves were performed using the log-rank test. Logistic regression analysis was performed to determine the variable most predictive of PSA failure within 2 years of surgery.
  
  
  RESULTS
  At 10 years, the PSA failure-free survival rate, clinical failure-free survival rate, prostate cancer specific survival rate and overall survival rate of the 155 patients were 40.1%, 83.1%, 94.9% and 84.2%, respectively. The overall survival curve for patients with PSA failure within 2 years of surgery was significantly lower than for patients with no PSA failure within 2 years of surgery (P = 0.042). The multivariate logistic regression analysis demonstrated that PSA greater than 20 ng/mL and poor differentiation of the tumor were significant independent predictors of PSA failure within 2 years of surgery.
  
  
  CONCLUSIONS
  These results imply that prospective studies should be conducted to detect patients at high risk for PSA recurrence in whom metastasis may occur early and to investigate postoperative treatments for these high-risk patients to improve overall survival.
authors.affiliation: Department of Urology, Surugadai Nihon University Hospital, Tokyo, Japan. hachiya@med.nihon-u.ac.jp
authors.forename: Takahiko
authors.initials: T
authors.lastname: Hachiya
authors.forename: Taketo
authors.initials: T
authors.lastname: Ichinose
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Hirakata
authors.forename: Nozomu
authors.initials: N
authors.lastname: Kawata
authors.forename: Kiyoki
authors.initials: K
authors.lastname: Okada
authors.forename: Yukie
authors.initials: Y
authors.lastname: Takimoto
mesh_terms: D000368:Aged; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000401:mortality / Q000601:surgery; D015996:Survival Rate / Q000639:trends; D013997:Time Factors
chemical_list: D017430:Prostate-Specific Antigen