Prediction of biochemical failure using prostate-specific antigen half-life in patients with adverse pathologic features after radical prostatectomy
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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.
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.
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.
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.
KeywordsPatient outcome assessment Prostate Prostate cancer Prostatectomy
KSL: project development, manuscript writing; KCK: manuscript writing/editing; BHC: project development, manuscript writing.
Compliance with ethical standards
Conflict of interest
There is no potential conflict of interest.
Human and animal rights
Clinical research involving human participants but no animals.
The study was approved by our institutional review board.
Due to the retrospective nature of the study, written informed consent was waived.
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