Biochemical outcome after radical prostatectomy among men with normal preoperative serum prostate-specific antigen levels

Stephen J. Freedland, William J. Aronson, Christopher J. Kane, Martha Kennedy Terris, Joseph C. Presti, Bruce Trock, Christopher L. Amling

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

BACKGROUND. Recent studies have shown that a significant number of men with normal prostate-specific antigen (PSA) levels have prostate carcinoma. Whether malignancies in such men are associated with better outcomes is unclear. The authors compared the risk of biochemical failure after radical prostatectomy (RP) between men with normal PSA levels and men with elevated PSA levels. METHODS. Data were examined from 1582 men who underwent RP between 1988 and 2002 at 1 of 5 equal-access medical centers. Patients were segregated into groups based on serum PSA levels (with stratification according to age-specific reference ranges). Clinical and pathologic characteristics and biochemical outcome data were compared across groups using analyses of variance, log-rank tests, and Cox proportional hazards analysis. RESULTS. Men who had normal PSA levels had significantly fewer high-grade tumors compared with men who had higher PSA levels (P < 0.001). The former group had a significantly decreased incidence of positive surgical margins, extracapsular disease, seminal vesicle invasion, and lymph node involvement (P < 0.001). On multivariate analysis, only serum PSA level (P < 0.001) and biopsy Gleason score (P < 0.001) predicted the time to disease recurrence. When only men with serum PSA levels < 10 ng/mL were examined, PSA level treated as a continuous variable remained a significant predictor of time to biochemical failure (P = 0.02). CONCLUSIONS. Men who had normal PSA levels had significantly fewer high-grade tumors and significantly better biochemical outcomes after undergoing RP compared with men who had elevated PSA levels. Overall, men with normal PSA levels who undergo RP represent a favorable risk group.

Original languageEnglish (US)
Pages (from-to)748-753
Number of pages6
JournalCancer
Volume101
Issue number4
DOIs
StatePublished - Aug 15 2004

Fingerprint

Prostate-Specific Antigen
Prostatectomy
Serum
Neoplasms
Neoplasm Grading
Seminal Vesicles
Prostate
Analysis of Variance
Reference Values
Multivariate Analysis
Lymph Nodes
Carcinoma
Biopsy
Recurrence

Keywords

  • Prostate carcinoma
  • Prostate-specific antigen
  • Prostate-specific antigen recurrence
  • Radical prostatectomy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Freedland, S. J., Aronson, W. J., Kane, C. J., Terris, M. K., Presti, J. C., Trock, B., & Amling, C. L. (2004). Biochemical outcome after radical prostatectomy among men with normal preoperative serum prostate-specific antigen levels. Cancer, 101(4), 748-753. https://doi.org/10.1002/cncr.20390

Biochemical outcome after radical prostatectomy among men with normal preoperative serum prostate-specific antigen levels. / Freedland, Stephen J.; Aronson, William J.; Kane, Christopher J.; Terris, Martha Kennedy; Presti, Joseph C.; Trock, Bruce; Amling, Christopher L.

In: Cancer, Vol. 101, No. 4, 15.08.2004, p. 748-753.

Research output: Contribution to journalArticle

Freedland, Stephen J. ; Aronson, William J. ; Kane, Christopher J. ; Terris, Martha Kennedy ; Presti, Joseph C. ; Trock, Bruce ; Amling, Christopher L. / Biochemical outcome after radical prostatectomy among men with normal preoperative serum prostate-specific antigen levels. In: Cancer. 2004 ; Vol. 101, No. 4. pp. 748-753.
@article{96546477e7b24a5c915a8345757aaf2e,
title = "Biochemical outcome after radical prostatectomy among men with normal preoperative serum prostate-specific antigen levels",
abstract = "BACKGROUND. Recent studies have shown that a significant number of men with normal prostate-specific antigen (PSA) levels have prostate carcinoma. Whether malignancies in such men are associated with better outcomes is unclear. The authors compared the risk of biochemical failure after radical prostatectomy (RP) between men with normal PSA levels and men with elevated PSA levels. METHODS. Data were examined from 1582 men who underwent RP between 1988 and 2002 at 1 of 5 equal-access medical centers. Patients were segregated into groups based on serum PSA levels (with stratification according to age-specific reference ranges). Clinical and pathologic characteristics and biochemical outcome data were compared across groups using analyses of variance, log-rank tests, and Cox proportional hazards analysis. RESULTS. Men who had normal PSA levels had significantly fewer high-grade tumors compared with men who had higher PSA levels (P < 0.001). The former group had a significantly decreased incidence of positive surgical margins, extracapsular disease, seminal vesicle invasion, and lymph node involvement (P < 0.001). On multivariate analysis, only serum PSA level (P < 0.001) and biopsy Gleason score (P < 0.001) predicted the time to disease recurrence. When only men with serum PSA levels < 10 ng/mL were examined, PSA level treated as a continuous variable remained a significant predictor of time to biochemical failure (P = 0.02). CONCLUSIONS. Men who had normal PSA levels had significantly fewer high-grade tumors and significantly better biochemical outcomes after undergoing RP compared with men who had elevated PSA levels. Overall, men with normal PSA levels who undergo RP represent a favorable risk group.",
keywords = "Prostate carcinoma, Prostate-specific antigen, Prostate-specific antigen recurrence, Radical prostatectomy",
author = "Freedland, {Stephen J.} and Aronson, {William J.} and Kane, {Christopher J.} and Terris, {Martha Kennedy} and Presti, {Joseph C.} and Bruce Trock and Amling, {Christopher L.}",
year = "2004",
month = "8",
day = "15",
doi = "10.1002/cncr.20390",
language = "English (US)",
volume = "101",
pages = "748--753",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "4",

}

TY - JOUR

T1 - Biochemical outcome after radical prostatectomy among men with normal preoperative serum prostate-specific antigen levels

AU - Freedland, Stephen J.

AU - Aronson, William J.

AU - Kane, Christopher J.

AU - Terris, Martha Kennedy

AU - Presti, Joseph C.

AU - Trock, Bruce

AU - Amling, Christopher L.

PY - 2004/8/15

Y1 - 2004/8/15

N2 - BACKGROUND. Recent studies have shown that a significant number of men with normal prostate-specific antigen (PSA) levels have prostate carcinoma. Whether malignancies in such men are associated with better outcomes is unclear. The authors compared the risk of biochemical failure after radical prostatectomy (RP) between men with normal PSA levels and men with elevated PSA levels. METHODS. Data were examined from 1582 men who underwent RP between 1988 and 2002 at 1 of 5 equal-access medical centers. Patients were segregated into groups based on serum PSA levels (with stratification according to age-specific reference ranges). Clinical and pathologic characteristics and biochemical outcome data were compared across groups using analyses of variance, log-rank tests, and Cox proportional hazards analysis. RESULTS. Men who had normal PSA levels had significantly fewer high-grade tumors compared with men who had higher PSA levels (P < 0.001). The former group had a significantly decreased incidence of positive surgical margins, extracapsular disease, seminal vesicle invasion, and lymph node involvement (P < 0.001). On multivariate analysis, only serum PSA level (P < 0.001) and biopsy Gleason score (P < 0.001) predicted the time to disease recurrence. When only men with serum PSA levels < 10 ng/mL were examined, PSA level treated as a continuous variable remained a significant predictor of time to biochemical failure (P = 0.02). CONCLUSIONS. Men who had normal PSA levels had significantly fewer high-grade tumors and significantly better biochemical outcomes after undergoing RP compared with men who had elevated PSA levels. Overall, men with normal PSA levels who undergo RP represent a favorable risk group.

AB - BACKGROUND. Recent studies have shown that a significant number of men with normal prostate-specific antigen (PSA) levels have prostate carcinoma. Whether malignancies in such men are associated with better outcomes is unclear. The authors compared the risk of biochemical failure after radical prostatectomy (RP) between men with normal PSA levels and men with elevated PSA levels. METHODS. Data were examined from 1582 men who underwent RP between 1988 and 2002 at 1 of 5 equal-access medical centers. Patients were segregated into groups based on serum PSA levels (with stratification according to age-specific reference ranges). Clinical and pathologic characteristics and biochemical outcome data were compared across groups using analyses of variance, log-rank tests, and Cox proportional hazards analysis. RESULTS. Men who had normal PSA levels had significantly fewer high-grade tumors compared with men who had higher PSA levels (P < 0.001). The former group had a significantly decreased incidence of positive surgical margins, extracapsular disease, seminal vesicle invasion, and lymph node involvement (P < 0.001). On multivariate analysis, only serum PSA level (P < 0.001) and biopsy Gleason score (P < 0.001) predicted the time to disease recurrence. When only men with serum PSA levels < 10 ng/mL were examined, PSA level treated as a continuous variable remained a significant predictor of time to biochemical failure (P = 0.02). CONCLUSIONS. Men who had normal PSA levels had significantly fewer high-grade tumors and significantly better biochemical outcomes after undergoing RP compared with men who had elevated PSA levels. Overall, men with normal PSA levels who undergo RP represent a favorable risk group.

KW - Prostate carcinoma

KW - Prostate-specific antigen

KW - Prostate-specific antigen recurrence

KW - Radical prostatectomy

UR - http://www.scopus.com/inward/record.url?scp=3543108390&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=3543108390&partnerID=8YFLogxK

U2 - 10.1002/cncr.20390

DO - 10.1002/cncr.20390

M3 - Article

VL - 101

SP - 748

EP - 753

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 4

ER -