Time To Prostate Specific Antigen Recurrence After Radical Prostatectomy And Risk Of Prostate Cancer Specific Mortality

UroToday.com - Aside from preoperative PSA, Gleason score, and pathologic stage, surrogate markers for prostate cancer-related death after prostatectomy include PSA doubling time and the length of time from surgery to PSA recurrence.

In the October issue of the Journal of Urology, Freedland and co-workers from Johns Hopkins performed a detailed analysis of a contemporary series of 379 patients who developed disease recurrence after radical prostatectomy.

The authors found that disease-specific survival significantly decreased if the PSA recurrence occurred 3 years after surgery, with a hazard ratio of 2.70 (95% confidence interval, 1.37 to 5.31, p = 0.004). The 15-year estimated survival for patients with disease recurrence less than 3 years after surgery was 41% (95% CI 29 to 53) compared to 87% in those with recurrence 3 years after prostatectomy.

These data provide additional evidence that PSA recurrence within 3 years of surgery may serve as a surrogate marker for prostate cancer death. Most importantly, this information provides reassurance that the majority of patients with surgically-treated prostate cancer who recur after 3 years will not die of their disease.

J Urol. 2006 Oct;176(4 Pt 1):1404-1408.
Reviewed By UroToday.com Contributing Editor Ricardo F. SГЎnchez-Ortiz, MD

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