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

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.