title: Prostate-specific antigen measured 3 months after radical prostatectomy as a new predictor of biochemical recurrence.
abstract: BACKGROUND
  This study was undertaken to investigate if the prostate-specific antigen (PSA) level measured 3 months after radical prostatectomy (RP) is a predictor of biochemical recurrence (BCR)-free survival.
  
  
  METHODS
  We retrospectively reviewed the clinicopathologic data of 174 patients with a follow-up of at least 3 years after RP for clinically localized prostate cancer. None of the patients received neoadjuvant/adjuvant therapy. Subjects were categorized according to PSA level 3 months after RP (3M-PSA): <0.010 ng/mL (group 1; n = 119) or 0.010-0.100 ng/mL (group 2; n = 55). BCR was defined as two consecutive rises in PSA level ≥0.2 ng/mL.
  
  
  RESULTS
  At a median follow-up of 69.5 months (range 36-113 months), 32 (18.4 %) patients experienced BCR. The median time to BCR was 16 months (range 4-98 months) after RP. The 5-year BCR-free survival rate was 92.6 and 57.4 % in groups 1 and 2, respectively. Patients in group 1 had a significantly higher BCR-free survival rate than those in group 2 (log-rank P < 0.001). According to the Cox proportional hazards model, patients with a 3M-PSA level of <0.010 ng/mL were at lower risk for BCR (P < 0.001), along with pathologic Gleason sum 6 (P = 0.028). PSA nadir level after RP was also a risk factor for BCR (log-rank P < 0.001). Area under the receiver operating characteristic curve for 3M-PSA to predict BCR was almost equivalent to that for the PSA nadir level (0.855 vs. 0.849).
  
  
  CONCLUSIONS
  3M-PSA is an independent predictor of BCR-free survival. Our findings might be used for a risk-adjusted follow-up protocol.
authors.affiliation: Department of Urology, Ikeda Municipal Hospital, 3-1-18 Jonan, Ikeda, Osaka, 563-8510, Japan, hiinoue2000@yahoo.co.jp.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Inoue
authors.forename: Kensaku
authors.initials: K
authors.lastname: Nishimura
authors.forename: Seiji
authors.initials: S
authors.lastname: Yamaguchi
authors.forename: Norio
authors.initials: N
authors.lastname: Nonomura
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Hara
mesh_terms: D000368:Aged; D018572:Disease-Free Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods; D060787:Neoplasm Grading / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D017430:Prostate-Specific Antigen / Q000378:metabolism*; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate
chemical_list: D017430:Prostate-Specific Antigen