Open AccessUltrasensitive prostate‐specific antigen level as a predictor of biochemical progression after robot‐assisted radical prostatectomy: Towards risk adapted follow‐up
Author(s) -
Grivas Nikolaos,
Bruin Daan,
Barwari Kurdo,
Muilekom Erik,
Tillier Corinne,
Leeuwen Pim J.,
Wit Esther,
Kroese Wouter,
Poel Henk
Publication year - 2019
Publication title -
journal of clinical laboratory analysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.536
H-Index - 50
eISSN - 1098-2825
pISSN - 0887-8013
DOI - 10.1002/jcla.22693
Subject(s) - prostatectomy , medicine , biochemical recurrence , urology , prostate cancer , prostate specific antigen , breakpoint cluster region , odds ratio , surgical margin , confidence interval , retrospective cohort study , cancer , receptor
Background Ultrasensitive prostate‐specific antigen (USPSA) is useful for stratifying patients according to their USPSA‐based risk. Aim of our study was to determine the usefulness of USPSA as predictor of biochemical recurrence (BCR) after robot‐assisted radical prostatectomy (RARP). Methods This retrospective study included 213 prostate cancer patients who had a postoperative USPSA between 0.01 and 0.2 ng/mL and at least 2 years of follow‐up. We developed predictive models for BCR with PSA ≥0.2 and ≥0.5 ng/mL. Results A total of 103 patients (48.3%) had BCR at a median follow‐up of 13.3 months. Higher postoperative USPSA (odds ratio [OR] = 4.73, P < 0.01), bilateral positive surgical margin in both sides (OR = 1.32, P = 0.044), higher average PSA rise (OR = 1.67, P = 0.031), ISUP grade group ≥3 (OR = 1.48, P = 0.003), and shorter interval since RARP (OR = 0.58, P < 0.001) were independent predictors of BCR with PSA ≥0.2 ng/mL. Higher postoperative USPSA (OR = 3.85, P < 0.01), bilateral positive surgical margin (OR = 1.34, P = 0.011), ISUP grade group ≥3 (OR = 1.5, P = 0.002), and shorter interval since RARP (OR = 0.61, P = 0.001) were independent predictors of BCR with PSA ≥0.5 ng/mL. The areas under the curve for the first and second model were 0.865 and 0.834, respectively. Conclusion Ultrasensitive PSA after RARP is a useful prognostic indicator of BCR which could guide postoperative risk stratification and layout follow‐up scheduling.