Timing of Prostate-specific Antigen Nadir After Radical Prostatectomy and Risk of Biochemical Recurrence

Stephanie L. Skove, Lauren E. Howard, William J. Aronson, Martha Kennedy Terris, Christopher J. Kane, Christopher L. Amling, Matthew R. Cooperberg, Daniel M. Moreira, Stephen J. Freedland

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objective To evaluate the association between the prostate-specific antigen (PSA) nadir level and the time to nadir (TTN) with biochemical recurrence (BCR) risk after radical prostatectomy (RP) in the Shared Equal-Access Research Cancer Hospital (SEARCH) database. Materials and Methods This is a retrospective analysis of 1939 men from the SEARCH database treated with RP between 1998 and 2015 with available ultrasensitive PSA nadir within 1-6 months after RP. Uni- and multivariable analyses of PSA nadir and TTN with time from nadir to BCR were performed with Cox models (adjusted for demographics, tumor features, and preoperative PSA). Results Among men with an undetectable PSA nadir, the TTN was unrelated to BCR (1.0-2.9 vs 3-6 months: hazard ratio [HR] 0.86, P =.46). Regardless of TTN, men with detectable nadir had an increased risk of BCR (TTN of 3-6 months: HR 1.81, P =.024; TTN of 1.0-2.99 months: HR 3.75, P <.001 vs undetectable nadir and TTN of 3-6 months). Among men with a detectable PSA at 1-3 months, 53% had a lower PSA level during follow-up 3-6 months after RP, which was undetectable in 32% and lower but still detectable in 21%. Conclusion 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 PSA level during follow-up between 3 and 6 months after RP. If confirmed in future studies, this has important implications for patients considering adjuvant therapy based on postoperative PSA values in the first 3 months after RP.

Original languageEnglish (US)
Pages (from-to)129-134
Number of pages6
JournalUrology
Volume108
DOIs
StatePublished - Oct 1 2017

Fingerprint

Prostate-Specific Antigen
Prostatectomy
Recurrence
Cancer Care Facilities
Databases
Proportional Hazards Models
Research
Demography

ASJC Scopus subject areas

  • Urology

Cite this

Skove, S. L., Howard, L. E., Aronson, W. J., Terris, M. K., Kane, C. J., Amling, C. L., ... Freedland, S. J. (2017). Timing of Prostate-specific Antigen Nadir After Radical Prostatectomy and Risk of Biochemical Recurrence. Urology, 108, 129-134. https://doi.org/10.1016/j.urology.2017.07.009

Timing of Prostate-specific Antigen Nadir After Radical Prostatectomy and Risk of Biochemical Recurrence. / Skove, Stephanie L.; Howard, Lauren E.; Aronson, William J.; Terris, Martha Kennedy; Kane, Christopher J.; Amling, Christopher L.; Cooperberg, Matthew R.; Moreira, Daniel M.; Freedland, Stephen J.

In: Urology, Vol. 108, 01.10.2017, p. 129-134.

Research output: Contribution to journalArticle

Skove, SL, Howard, LE, Aronson, WJ, Terris, MK, Kane, CJ, Amling, CL, Cooperberg, MR, Moreira, DM & Freedland, SJ 2017, 'Timing of Prostate-specific Antigen Nadir After Radical Prostatectomy and Risk of Biochemical Recurrence', Urology, vol. 108, pp. 129-134. https://doi.org/10.1016/j.urology.2017.07.009
Skove, Stephanie L. ; Howard, Lauren E. ; Aronson, William J. ; Terris, Martha Kennedy ; Kane, Christopher J. ; Amling, Christopher L. ; Cooperberg, Matthew R. ; Moreira, Daniel M. ; Freedland, Stephen J. / Timing of Prostate-specific Antigen Nadir After Radical Prostatectomy and Risk of Biochemical Recurrence. In: Urology. 2017 ; Vol. 108. pp. 129-134.
@article{7b6a02ad5e5d45dd88bb582ae32d5a46,
title = "Timing of Prostate-specific Antigen Nadir After Radical Prostatectomy and Risk of Biochemical Recurrence",
abstract = "Objective To evaluate the association between the prostate-specific antigen (PSA) nadir level and the time to nadir (TTN) with biochemical recurrence (BCR) risk after radical prostatectomy (RP) in the Shared Equal-Access Research Cancer Hospital (SEARCH) database. Materials and Methods This is a retrospective analysis of 1939 men from the SEARCH database treated with RP between 1998 and 2015 with available ultrasensitive PSA nadir within 1-6 months after RP. Uni- and multivariable analyses of PSA nadir and TTN with time from nadir to BCR were performed with Cox models (adjusted for demographics, tumor features, and preoperative PSA). Results Among men with an undetectable PSA nadir, the TTN was unrelated to BCR (1.0-2.9 vs 3-6 months: hazard ratio [HR] 0.86, P =.46). Regardless of TTN, men with detectable nadir had an increased risk of BCR (TTN of 3-6 months: HR 1.81, P =.024; TTN of 1.0-2.99 months: HR 3.75, P <.001 vs undetectable nadir and TTN of 3-6 months). Among men with a detectable PSA at 1-3 months, 53{\%} had a lower PSA level during follow-up 3-6 months after RP, which was undetectable in 32{\%} and lower but still detectable in 21{\%}. Conclusion 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 PSA level during follow-up between 3 and 6 months after RP. If confirmed in future studies, this has important implications for patients considering adjuvant therapy based on postoperative PSA values in the first 3 months after RP.",
author = "Skove, {Stephanie L.} and Howard, {Lauren E.} and Aronson, {William J.} and Terris, {Martha Kennedy} and Kane, {Christopher J.} and Amling, {Christopher L.} and Cooperberg, {Matthew R.} and Moreira, {Daniel M.} and Freedland, {Stephen J.}",
year = "2017",
month = "10",
day = "1",
doi = "10.1016/j.urology.2017.07.009",
language = "English (US)",
volume = "108",
pages = "129--134",
journal = "Urology",
issn = "0090-4295",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Timing of Prostate-specific Antigen Nadir After Radical Prostatectomy and Risk of Biochemical Recurrence

AU - Skove, Stephanie L.

AU - Howard, Lauren E.

AU - Aronson, William J.

AU - Terris, Martha Kennedy

AU - Kane, Christopher J.

AU - Amling, Christopher L.

AU - Cooperberg, Matthew R.

AU - Moreira, Daniel M.

AU - Freedland, Stephen J.

PY - 2017/10/1

Y1 - 2017/10/1

N2 - Objective To evaluate the association between the prostate-specific antigen (PSA) nadir level and the time to nadir (TTN) with biochemical recurrence (BCR) risk after radical prostatectomy (RP) in the Shared Equal-Access Research Cancer Hospital (SEARCH) database. Materials and Methods This is a retrospective analysis of 1939 men from the SEARCH database treated with RP between 1998 and 2015 with available ultrasensitive PSA nadir within 1-6 months after RP. Uni- and multivariable analyses of PSA nadir and TTN with time from nadir to BCR were performed with Cox models (adjusted for demographics, tumor features, and preoperative PSA). Results Among men with an undetectable PSA nadir, the TTN was unrelated to BCR (1.0-2.9 vs 3-6 months: hazard ratio [HR] 0.86, P =.46). Regardless of TTN, men with detectable nadir had an increased risk of BCR (TTN of 3-6 months: HR 1.81, P =.024; TTN of 1.0-2.99 months: HR 3.75, P <.001 vs undetectable nadir and TTN of 3-6 months). Among men with a detectable PSA at 1-3 months, 53% had a lower PSA level during follow-up 3-6 months after RP, which was undetectable in 32% and lower but still detectable in 21%. Conclusion 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 PSA level during follow-up between 3 and 6 months after RP. If confirmed in future studies, this has important implications for patients considering adjuvant therapy based on postoperative PSA values in the first 3 months after RP.

AB - Objective To evaluate the association between the prostate-specific antigen (PSA) nadir level and the time to nadir (TTN) with biochemical recurrence (BCR) risk after radical prostatectomy (RP) in the Shared Equal-Access Research Cancer Hospital (SEARCH) database. Materials and Methods This is a retrospective analysis of 1939 men from the SEARCH database treated with RP between 1998 and 2015 with available ultrasensitive PSA nadir within 1-6 months after RP. Uni- and multivariable analyses of PSA nadir and TTN with time from nadir to BCR were performed with Cox models (adjusted for demographics, tumor features, and preoperative PSA). Results Among men with an undetectable PSA nadir, the TTN was unrelated to BCR (1.0-2.9 vs 3-6 months: hazard ratio [HR] 0.86, P =.46). Regardless of TTN, men with detectable nadir had an increased risk of BCR (TTN of 3-6 months: HR 1.81, P =.024; TTN of 1.0-2.99 months: HR 3.75, P <.001 vs undetectable nadir and TTN of 3-6 months). Among men with a detectable PSA at 1-3 months, 53% had a lower PSA level during follow-up 3-6 months after RP, which was undetectable in 32% and lower but still detectable in 21%. Conclusion 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 PSA level during follow-up between 3 and 6 months after RP. If confirmed in future studies, this has important implications for patients considering adjuvant therapy based on postoperative PSA values in the first 3 months after RP.

UR - http://www.scopus.com/inward/record.url?scp=85028078714&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85028078714&partnerID=8YFLogxK

U2 - 10.1016/j.urology.2017.07.009

DO - 10.1016/j.urology.2017.07.009

M3 - Article

VL - 108

SP - 129

EP - 134

JO - Urology

JF - Urology

SN - 0090-4295

ER -