Original ArticlePSA Doubling Time as a Predictor of Clinical Progression After Biochemical Failure Following Radical Prostatectomy for Prostate Cancer
Section snippets
PATIENTS AND METHODS
A total of 2809 patients were treated with primary bilateral pelvic lymphadenectomy and RRP at Mayo Clinic, Rochester, Minn, for clinically localized (cT½) adenocarcinoma of the prostate between 1987 and 1993. All patients were entered into the Mayo Clinic radical prostatectomy database. Pathologic staging and grading were performed on histopathologic examination of the entire specimen, as previously described.11 Histopathologic grading was performed according to the Gleason grading system.12
RESULTS
Table 1 shows the pathologic stages, Gleason scores, DNA ploidy status, and preoperative PSA in all patients in each cohort. A total of 879 men (31% of the RRP cohort) had biochemical failure during the follow-up period. The mean time from RRP to biochemical failure was 2.9 years (median, 2.4 years). Of those who developed biochemical failure, 84% did so within 5 years of their surgery. In the cohort of 2809 men, the median number of PSA measurements during the follow-up time was 1.03 per man
DISCUSSION
The majority of men undergoing radical prostatectomy for clinically localized (T½) prostate cancer are cured by the procedure; however, in approximately one third of men, a PSA elevation develops during long-term follow-up.2, 3, 4, 5, 6, 7 Data are lacking regarding how best to manage these men with a PSA relapse; no prospective trials have been performed, and until recently, the long-term risk of clinical progression in these patients was unknown.8, 9 In this study it was our intent to
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Dr Roberts is now with Urology Associates, Scottsdale, Ariz.