DURHAM, NC—What is the association between lowest prostate-specific antigen (PSA) and time to nadir with biochemical recurrence (BCR) risk after radical prostatectomy (RP)?
A study published recently in the journal Urology used the SEARCH database to try to answer that question.1
Durham, NC, VAMC researchers and colleagues performed a retrospective analysis of 1,939 men from the SEARCH database treated with RP between 1998-2015 with available ultrasensitive PSA nadir within one to six after RP.
Results indicated that, among men with an undetectable PSA nadir, the TTN was unrelated to BCR—1-2.9 vs. 3-6 months for a hazard ratio of 0.86. Despite TTN, men with detectable nadir had increased risk of BCR—TTN 3-6 months: HR 1.81; TTN 1-2.99 months: HR 3.75 vs. undetectable nadir and TTN 3-6 months, the study noted.
The findings also suggested that, among men with a detectable PSA at 1-3 months, 53% had a lower follow-up PSA three to six months after RP which was undetectable in 32% and lower but still detectable in 21%.
“In the post-RP setting, men with both a detectable nadir and a shorter TTN had an increased risk of BCR. Intriguingly, about half of the men with a detectable PSA in the first 3 months after RP had a lower follow-up PSA between 3 and 6 months after RP,” study authors concluded. “If confirmed in future studies, this has important implications for patients considering adjuvant therapy based upon post-operative PSA values in the first 3 months after RP.”
1. Skove SL, Howard LE, Aronson WJ, Terris MK, Kane CJ, Amling CL, Cooperberg MR, Moreira DM, Freedland SJ. Timing of PSA Nadir after Radical Prostatectomy and Risk of Biochemical Recurrence. Urology. 2017 Jul 19. pii: S0090-4295(17)30742-2. doi: 10.1016/j.urology.2017.07.009. [Epub ahead of print] PubMed PMID: 28735016.