Cancer - Prostate(구연) (E-143)

Biochemical recurrence after radical prostatectomy according to nadir prostate specific antigen value
성균관의대 삼성서울병원 비뇨의학과교실, ¹성균관의대 강북삼성병원 비뇨의학과교실
정재훈, 정재용¹, 송완, 강민용, 성현환, 전황균, 정병창, 서성일, 이현무, 전성수
Aim: The hypersensitive prostate specific antigen (PSA) test can measure at 0.01 ng/mL units, and its efficacy for screening after radical prostatectomy (RP) has been reported. In this study, we assessed the patients who underwent RP to evaluate whether the nadir value affects biochemical recurrence (BCR).
Materials and Methods: From 1995 to 2014, the patients classified as N0, had negative resection margin and a nadir PSA of less than 0.2 ng/mL were evaluated. The characteristics, pathological outcomes, PSA after RP and BCR were assessed.
Results: A total of 1483 patients were enrolled. Among them, 323 (21.78%) patients showed BCR after RP. The mean preoperative PSA of the BCR group was 9.75±6.92 ng/mL and that of the no-recurrence group was 6.71±5.19 ng/mL (P < 0.001). The mean time to nadir (TTN) in the BCR group was 4.64±7.65 months and 7.43±12.46 months in the no-recurrence group (P < 0.001). In the BCR group, the mean PSA nadir value was 0.035±0.034 ng/mL and the mean nadir value in the no-recurrence group was 0.014±0.009 ng/mL (P < 0.001). In multivariable Cox regression analyses, Gleason score, positive biopsy core percentages, minimal invasive surgery, nadir PSA value, and TTN were associated with BCR, independently (Table 1) (Figure 1). The mean BCR occurred at 48.23±2.01 months after RP, and there was a significant difference in BCR occurrence according to nadir PSA value (P <0.001).
Conclusions: High PSA nadir value and short TTN may predict the risk of BCR after successful RP. This may identify candidates for adjuvant or salvage therapies after RP.
keywords : PROSTATE CANCER, PROSTATE SPECIFIC ANTIGEN, RECURRENCE

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