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Predictors of Persistent Prostate-Specific Antigen Persistence after Radical Prostatectomy.

Chenhao Guo1, Kangwei Zuo1, Qi Zhao1

  • 1Department of Urology, Lanzhou University First Hospital, Lanzhou University, Lanzhou, China.

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
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Summary

High levels of total PSA (tPSA) and free PSA (fPSA) at diagnosis, along with advanced clinical T stage, predict persistent prostate-specific antigen (PSA) after radical prostatectomy (RP). This finding aids in identifying patients at risk for recurrence.

Keywords:
persistenceprostate cancerprostate-specific antigenradical prostatectomy

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Area of Science:

  • Urology
  • Oncology
  • Medical Research

Background:

  • Prostate-specific antigen (PSA) monitoring is crucial after radical prostatectomy (RP) for prostate cancer.
  • Persistent PSA post-RP can indicate residual disease or recurrence.
  • Identifying predictors of persistent PSA is essential for patient management and prognosis.

Purpose of the Study:

  • To investigate the predictors of persistent prostate-specific antigen (PSA) after radical prostatectomy (RP).
  • To establish a logistic regression equation for predicting the probability of persistent PSA.

Main Methods:

  • Retrospective analysis of 212 prostate cancer patients who underwent RP between January 2019 and December 2022.
  • Patients were categorized based on postoperative PSA levels (4-8 weeks) into <0.1 ng/mL and ≥0.1 ng/mL groups.
  • Logistic regression analysis was employed to identify independent risk factors for persistent PSA.

Main Results:

  • Elevated total PSA (tPSA) levels at diagnosis (>49.73 ng/mL) were identified as a significant predictor.
  • Elevated free PSA (fPSA) levels at diagnosis (>2.07 ng/mL) emerged as an independent risk factor.
  • Clinical T stage >T3a, specifically T3b, was strongly associated with persistent PSA after RP.

Conclusions:

  • Preoperative tPSA >49.73 ng/mL, fPSA >2.07 ng/mL, and T3b stage are independent risk factors for persistent PSA post-RP.
  • These factors can aid in predicting the likelihood of persistent PSA in prostate cancer patients.
  • Early identification of patients at risk can inform treatment strategies and follow-up protocols.