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. 2019 Jun 25:11:5777-5783.
doi: 10.2147/CMAR.S197521. eCollection 2019.

Prognostic significance of a novel indicator (PSApostd3/PSApre) for PSA recurrence in patients after radical prostatectomy

Zhien Zhou #  1 , Yinyan Xu #  2 , Qianyue Li  3 , Weigang Yan  1 , Yi Zhou  1 , Zhibo Zheng  1 , Hanzhong Li  1 , Zhigang Ji  1
Affiliations

Prognostic significance of a novel indicator (PSApostd3/PSApre) for PSA recurrence in patients after radical prostatectomy

Zhien Zhou et al. Cancer Manag Res. .

Abstract

Purpose: Radical prostatectomy (RP) is a common treatment for prostate cancer, but a fraction of patients may experience PSA recurrence after surgery, manifesting as an elevation in prostate specific antigen (PSA). Vast literature has reported different prognostic factors for PSA recurrence without reaching a consensus. This retrospective study investigated the efficacy of a new indicator in predicting PSA recurrence in patients after RP.

Patients and methods: From October 2000 to December 2015, 102 PCa patients who underwent laparoscopic prostatectomy in the Urology Department of Peking Union Medical College Hospital were analyzed. We calculated PSApostd3/PSApre, defined as the ratio of the PSA on day 3 postop as the numerator and the pre-operative PSA as the denominator, in these patients to represent PSA decrement after surgery, and investigated its relationship with PSA recurrence during follow-up.

Results: The receiver operating characteristic (ROC) curve of PSApostd3/PSApre derived a cut-off at 0.453 (sensitivity=0.704, specificity=0.853, P<0.0001), suggesting an increased risk of PSA recurrence in patients whose PSA on day 3 postop did not decrease to approximately half of their preoperative levels. Among several factors, PSApostd3/PSApre (P<0.0001), pathological T stage (P=0.042) and Gleason Grade (P=0.021) were determined to be significantly associated with PSA recurrence by Fisher's exact test, while only PSApostd3/PSApre (P<0.001) was significantly related to PSA recurrence-free survival (PRFS) by multivariate logistic regression analysis.

Conclusion: These results imply that PSApostd3/PSApre could provide substantial information for PSA recurrence prediction in patients after RP.

Keywords: prognosis; prostate cancer; prostate-specific antigen.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Comparison of PSApostd3/PSApre between PSA recurrence groups and PSA recurrence-free groups. Abbreviation: PSApostd3/PSApre, The ratio of the prostate-specific antigen (PSA) on day 3 postop as the numerator and the pre-operative PSA as the denominator.
Figure 2
Figure 2
Receiver operating characteristic (ROC) curve of PSApostd3/PSApre to predict PSA recurrence (n=102, area under curve=0.760, cut-off=0.453, Youden=0.557, sensitivity=0.704, 1-specificity=0.147, P<0.0001). Abbreviation: PSApostd3/PSApre, The ratio of the prostate-specific antigen (PSA) on day 3 postop as the numerator and the pre-operative PSA as the denominator.
Figure 3
Figure 3
Kaplan-Meier estimates of the probability of PRFS according to PSApostd3/PSApre. Abbreviations: PRFS, PSA recurrence-free survival; PSApostd3/PSApre, The ratio of the prostate-specific antigen (PSA) on day 3 postop as the numerator and the pre-operative PSA as the denominator.
See this image and copyright information in PMC

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