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Risk assessment of late biochemical recurrence after radical prostatectomy: Usefulness of ultra-sensitive prostate-specific antigen measurement

  • 0Department of Urology, Osaka International Cancer Institute, Osaka, Japan.
International Journal of Urology : Official Journal of the Japanese Urological Association +

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December 24, 2024

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December 24, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

For prostate cancer patients with no recurrence 5 years after radical prostatectomy (RP), a prostate-specific antigen (PSA) level below 0.02 ng/mL indicates a very low risk of late recurrence. Ultra-sensitive PSA testing at 5 years can guide long-term follow-up strategies.

Area Of Science

  • Urology
  • Oncology
  • Medical Diagnostics

Background

  • Late biochemical recurrence after radical prostatectomy (RP) for prostate cancer remains a clinical concern.
  • Predictors for recurrence beyond 5 years post-RP require further investigation to optimize patient monitoring.
  • Current follow-up protocols may not fully capture the risk of late recurrence in select patient cohorts.

Purpose Of The Study

  • To identify predictors of late biochemical recurrence in patients with no recurrence at 5 years after RP.
  • To evaluate the utility of ultra-sensitive prostate-specific antigen (PSA) measurements in predicting long-term outcomes.
  • To assess the impact of tumor characteristics, such as Grade Group, on recurrence patterns.

Main Methods

  • Retrospective analysis of 312 patients who underwent RP for prostate cancer and had no biochemical recurrence at 5 years.
  • Utilized ultra-sensitive PSA measurements (detection limit 0.01 ng/mL) for regular patient monitoring post-RP.
  • Defined biochemical recurrence as PSA ≥0.2 ng/mL, confirmed by subsequent measurements, and analyzed predictors using multivariable regression.

Main Results

  • The 10-year biochemical recurrence-free survival rate for the cohort was 89.6%.
  • Patients with PSA <0.02 ng/mL at 5 years post-RP had a significantly higher 10-year recurrence-free survival rate (98.5%).
  • Grade Group ≥4 and PSA ≥0.02 ng/mL at 5 years post-RP were independent predictors of late biochemical recurrence (HR 2.23 and 37.5, respectively).

Conclusions

  • A PSA level below 0.02 ng/mL at 5 years after RP is associated with a very low risk of subsequent late biochemical recurrence.
  • Ultra-sensitive PSA measurements at the 5-year mark are valuable for stratifying patients and informing decisions about extended follow-up.
  • Grade Group is a significant factor influencing PSA doubling time and recurrence risk in patients post-RP.

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