title: Persistently elevated prostate-specific antigen at six weeks after radical prostatectomy helps in early identification of patients who are likely to recur.
abstract: OBJECTIVE
  To determine the prognostic factors of biochemical recurrence in patients who failed to achieve an undetectable prostate-specific antigen (PSA) after radical prostatectomy (RP) for prostate cancer.
  
  
  METHODS
  We reviewed data on 240 men who underwent RP as first-line treatment and who had a PSA assay available at 6 weeks after surgery. Persistent detectable PSA was defined as a PSA level ≥ 0.1 ng/ml at 6 weeks after surgery.
  
  
  RESULTS
  Overall, 83 men presented persistently elevated PSA after RP and 81 had a biochemical recurrence. Median follow-up was 44 months. In univariate analysis, these factors were associated with biochemical recurrence: preoperative PSA level (P < 0.0001), biopsy and pathologic Gleason score (P < 0.001), capsular involvement (P = 0.0001), positive surgical margins (P < 0.0001), pathological stage ≥ T3 (P = 0.0001), and detectable post-operative PSA ≥ 0.1 ng/ml (P = 0.0001). In a multivariate analysis, only the detectable post-operative PSA level ≥ 0.1 ng/mL (P = 0.001), positive surgical margins (P = 0.002), and pathological stage ≥ T3 (P < 0.001) were significant. The individual, five-year, PSA-free survival rate for men with post-operative PSA <0.1 ng/ml and ≥ 0.1 ng/ml were 59 and 42%, respectively (P < 0.001).
  
  
  CONCLUSIONS
  A majority of patients who failed to achieve an undetectable PSA after surgery had a subsequent biochemical recurrence in the outcome. A systematic PSA assay 6 weeks after RP could be useful to early identify patients who are likely to recur.
authors.affiliation: The Academic Department of Urology, Pathology and Statistics of La Pitié-Salpétrière, Groupe Hospitalo-Universitaire EST, Assistance-Publique Hôpitaux de Paris, 47-83 bvd de l'Hôpital, 75013 Paris, France.
authors.forename: François
authors.initials: F
authors.lastname: Audenet
authors.forename: Elise
authors.initials: E
authors.lastname: Seringe
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Drouin
authors.forename: Eva
authors.initials: E
authors.lastname: Comperat
authors.forename: Olivier
authors.initials: O
authors.lastname: Cussenot
authors.forename: Marc-Olivier
authors.initials: MO
authors.lastname: Bitker
authors.forename: Morgan
authors.initials: M
authors.lastname: Rouprêt
mesh_terms: D000368:Aged; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000175:diagnosis*; D011184:Postoperative Period; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000601:surgery; D012189:Retrospective Studies
chemical_list: D017430:Prostate-Specific Antigen