Do Ultrasensitive Prostate Specific Antigen Measurements Have a Role in Predicting Long-Term Biochemical Recurrence-Free Survival in Men after Radical Prostatectomy?

No AccessJournal of UrologyAdult Urology1 Feb 2016Do Ultrasensitive Prostate Specific Antigen Measurements Have a Role in Predicting Long-Term Biochemical Recurrence-Free Survival in Men after Radical Prostatectomy? Lori J. Sokoll, Zhen Zhang, Daniel W. Chan, Adam C. Reese, Trinity J. Bivalacqua, Alan W. Partin, and Patrick C. Walsh Lori J. SokollLori J. Sokoll Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, Maryland James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland More articles by this author , Zhen ZhangZhen Zhang Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, Maryland More articles by this author , Daniel W. ChanDaniel W. Chan Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, Maryland James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland More articles by this author , Adam C. ReeseAdam C. Reese James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland More articles by this author , Trinity J. BivalacquaTrinity J. Bivalacqua James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland More articles by this author , Alan W. PartinAlan W. Partin Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, Maryland James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland More articles by this author , and Patrick C. WalshPatrick C. Walsh James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.08.080AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: In this study we evaluate an ultrasensitive prostate specific antigen assay in patients with prostate cancer after radical prostatectomy to predict long-term biochemical recurrence-free survival. Materials and Methods: A total of 754 men who underwent radical prostatectomy and had an undetectable prostate specific antigen after surgery (less than 0.1 ng/ml) were studied. Prostate specific antigen was measured in banked serum specimens with an ultrasensitive assay (Hybritech® PSA, Beckman Coulter Access® 2) using a cutoff of 0.01 ng/ml. Prostate specific antigen was also measured in 44 men after cystoprostatectomy who had no pathological evidence of prostate cancer with the Hybritech assay and with the Quanterix AccuPSA™ assay. Results: Of the 754 men 17% (131) experienced biochemical recurrence (median 4.0 years). Those men without biochemical recurrence (83%, 623) had a minimum of 5 years of followup (median 11). Prostate specific antigen was less than 0.01 ng/ml in 93.4% of men with no biochemical recurrence, whereas 30.5% of men with biochemical recurrence had a prostate specific antigen of 0.01 ng/ml or greater. On multivariate analysis postoperative prostate specific antigen at a 0.01 ng/ml cutoff, pathological stage and Gleason score, and surgical margins were significant independent predictors of biochemical recurrence risk. Kaplan-Meier estimates for mean biochemical recurrence-free survival were 15.2 years (95% CI 14.9–15.6) for prostate specific antigen less than 0.01 ng/ml and 10.0 years (95% CI 8.4–11.5) for prostate specific antigen 0.01 ng/ml or greater (p <0.0001). Biochemical recurrence-free rates 11 years after surgery were 86.1% (95% CI 83.2–89.0) for prostate specific antigen less than 0.01 ng/ml and 48.9% (95% CI 37.5–60.3) for prostate specific antigen 0.01 ng/ml or greater (p <0.0001). Prostate specific antigen concentrations in 44 men after cystoprostatectomy were all less than 0.03 ng/ml, with 95.4% less than 0.01 ng/ml. Conclusions: In men with a serum prostate specific antigen less than 0.1 ng/ml after radical prostatectomy a tenfold lower cutoff (0.01 ng/ml) stratified biochemical recurrence-free survival and was a significant independent predictor of biochemical recurrence, as were pathological features. 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Link, Google Scholar © 2016 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byGreenberg S, Washington S, Lonergan P, Cowan J, Baskin A, Nguyen H, Odisho A, Simko J and Carroll P (2021) Residual Benign Prostate Glandular Tissue after Radical Prostatectomy is Not Associated with the Development of Detectable Postoperative Serum Prostate Specific AntigenJournal of Urology, VOL. 206, NO. 3, (706-714), Online publication date: 1-Sep-2021.Matsumoto K, Komatsuda A, Yanai Y, Niwa N, Kosaka T, Mizuno R, Kikuchi E, Miyajima A and Oya M (2016) Determining When to Stop Prostate Specific Antigen Monitoring after Radical Prostatectomy: the Role of Ultrasensitive Prostate Specific AntigenJournal of Urology, VOL. 197, NO. 3 Part 1, (655-661), Online publication date: 1-Mar-2017.Ellis W (2015) Should Clinicians Use Ultrasensitive Prostate Specific Antigen Measurements for Patient Evaluation?Journal of Urology, VOL. 195, NO. 2, (243-244), Online publication date: 1-Feb-2016. Volume 195Issue 2February 2016Page: 330-336Supplementary Materials Advertisement Copyright & Permissions© 2016 by American Urological Association Education and Research, Inc.Keywordsprostatic neoplasmsrecurrenceprostatectomyprostate-specific antigenAcknowledgmentsDebra Elliott and Elizabeth Humphreys contributed to this study.Metrics Author Information Lori J. Sokoll Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, Maryland James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland More articles by this author Zhen Zhang Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, Maryland More articles by this author Daniel W. Chan Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, Maryland James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland More articles by this author Adam C. Reese James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland More articles by this author Trinity J. Bivalacqua James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland More articles by this author Alan W. Partin Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, Maryland James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland More articles by this author Patrick C. Walsh James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland More articles by this author Expand All Advertisement PDF downloadLoading ...