PSA at postoperative three months can predict biochemical recurrence in patients with pathological T3 prostate cancer following radical prostatectomy.
OBJECTIVE
To identify the prognostic factors and determine which pT3 prostate cancer patients can be safely followed up after surgery without any adjuvant treatment.


METHODS
A retrospective review was carried out on 106 patients with pT3 prostate cancer. All preoperative and postoperative parameters, including the postoperative serum prostate-specific antigen (PSA) level at 3 months after surgery, were assessed by univariate and multivariate analyses.


RESULTS
Mean follow-up period was 18 months. The overall biochemical recurrence-free rate was 53.7% and 34.1% at 12 and 36 months, respectively. On univariate analysis, all preoperative clinical factors were significantly correlated with biochemical progression. On multivariate analysis, pathological Gleason score, pathological stage and postoperative PSA were significant predictors. Among those with undetectable PSA after surgery, 38 patients (88.4% of 43) did not have disease progression during the follow-up period. On the other hand, of the 27 patients with detectable PSA that was not defined as progressive (range 0.01-0.20), 22 (81.5%) had biochemical disease progression. The progression free probability was significantly different between these two groups (P-value < 0.0001).


CONCLUSIONS
pT3 prostate cancer patients showing low pathological Gleason score, without seminal vesicle invasion, and undetectable postoperative PSA values have low probability of PSA progression. Careful follow up including periodic PSA assessment and clinical observation represents an adequate strategy in the management of these patients.
Inagaki
Takeshi
T
Department of Urology, Wakayama Medical University, 811-1 Kimiidera,Wakayama 641-0012, Japan. tinagaki@wakayama-med.ac.jp
Kohjimoto
Yasuo
Y
Nishizawa
Satoshi
S
Kuramoto
Tomomi
T
Nanpo
Yoshihito
Y
Fujii
Reona
R
Matsumura
Nagahide
N
Shintani
Yasuyo
Y
Uekado
Yasunari
Y
Hara
Isao
I
D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D011183:Postoperative Complications / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors
D017430:Prostate-Specific Antigen