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Prediction of biochemical failure using prostate-specific antigen half-life in patients with adverse pathologic features after radical prostatectomy

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Abstract

Purpose

Prostate-specific antigen nadir and time to prostate-specific antigen nadir are predictors of disease progression in patients who undergo radical prostatectomy. However, a mutually conflicting relationship exists between them. Thus, we compared postoperative prostate-specific antigen levels at the first follow-up with the expected levels while considering the half-life of prostate-specific antigen to improve the prediction of biochemical failure after radical prostatectomy in patients with adverse pathologic features.

Methods

Patients treated with robot-assisted laparoscopic prostatectomy were enrolled. Patients with a follow-up duration of < 12 months or positive lymphadenectomy results were excluded. “Adverse prostate-specific antigen” was defined as a prostate-specific antigen level higher than the expected level at 6 weeks.

Results

Among 450 patients, adverse pathologic features and adverse prostate-specific antigen were found in 260 (57.8%) and 245 (54.5%) patients, respectively. Analysis of patients with and without abnormal prostate-specific antigen level revealed significantly different biochemical failure-free survival outcomes. Patients with one adverse pathologic feature but without adverse prostate-specific antigen showed similar biochemical failure-free survival to those without adverse pathologic features. Adverse prostate-specific antigen was identified as an independent predictor for biochemical failure within 1 year after radical prostatectomy. The area under the curve when adding adverse prostate-specific antigen to the conventional factors was significantly higher than that for the conventional factors alone.

Conclusion

The difference between postoperative prostate-specific antigen levels at the first follow-up visit after radical prostatectomy and the expected level while considering the half-life of prostate-specific antigen is a predictive factor for treatment efficacy following radical prostatectomy.

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Authors and Affiliations

  1. Department of Urology, Yonsei University College of Medicine, 211 Eonjuro, Gangnam-gu, Seoul, 135-720, South Korea

    Kwang Suk Lee, Kyo Chul Koo & Byung Ha Chung

Authors
  1. Kwang Suk Lee
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  2. Kyo Chul Koo
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  3. Byung Ha Chung
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Contributions

KSL: project development, manuscript writing; KCK: manuscript writing/editing; BHC: project development, manuscript writing.

Corresponding author

Correspondence to Byung Ha Chung.

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There is no potential conflict of interest.

Human and animal rights

Clinical research involving human participants but no animals.

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The study was approved by our institutional review board.

Informed consent

Due to the retrospective nature of the study, written informed consent was waived.

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Lee, K.S., Koo, K.C. & Chung, B.H. Prediction of biochemical failure using prostate-specific antigen half-life in patients with adverse pathologic features after radical prostatectomy. World J Urol 37, 1321–1328 (2019). https://doi.org/10.1007/s00345-018-2531-0

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  • DOI: https://doi.org/10.1007/s00345-018-2531-0

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