Significance of early prostate‐specific antigen values after salvage radiotherapy in recurrent prostate cancer patients treated with surgery. (10th September 2014)

• Record Type: Journal Article
• Authors: Chang, Ji Hyun; Park, Won; Park, Jun Su; Pyo, Hongryull; Huh, Seung Jae; Choi, Han Yong; Lee, Hyun Moo; Jeon, Seong Soo; Seo, Seong Il
• Is Part Of: International journal of urology. Volume 22:Number 1(2015)
• Page Start: 82
• Page End: 87
• Publication Date: 2014-09-10
• Subjects: Urology -- Periodicals; Genitourinary organs -- Periodicals; Urologic Diseases -- Periodicals; 616.6005
• DOI: 10.1111/iju.12604
• Languages: English
• ISSNs: 0919-8172

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="iju12604-sec-0001" sec-type="section"> <title>Objectives</title> <p>To assess the use of post‐salvage radiotherapy prostate‐specific antigen for early prediction of biochemical failure or clinical recurrence after salvage radiotherapy in recurrent prostate cancer patients after prostatectomy.</p> </sec> <sec id="iju12604-sec-0002" sec-type="section"> <title>Methods</title> <p>From 2000 to 2011, 164 patients were treated with salvage radiotherapy alone for recurrent prostate cancer. Patients who received androgen deprivation therapy before or within 1 month of the termination of salvage radiotherapy were excluded. Survival analysis was carried out with: (i) a selected prostate‐specific antigen reference value (0.2 ng/mL) at the second follow‐up period (4 months) after salvage radiotherapy (prostate‐specific antigen value over 0.2 ng/mL at post‐salvage radiotherapy 4 months); and (ii) prostate‐specific antigen percent decline (post‐salvage radiotherapy 4 months prostate‐specific antigen/pre‐salvage radiotherapy prostate‐specific antigen).</p> </sec> <sec id="iju12604-sec-0003" sec-type="section"> <title>Results</title> <p>The median follow‐up time was 53.4 months (range 8.5–134.1 months). The 5‐year clinical recurrence‐free survival was 87.9%. Prostate‐specific antigen percent decline of 0.45 was set as the cut‐off value for clinical recurrence‐free survival based on the receiver operating characteristics curve. In the multivariate analysis, a prostate‐specific antigen value over 0.2 ng/mL at post‐salvage radiotherapy 4 months (<italic>P</italic> = 0.013) and prostate‐specific antigen percent decline ≥ 0.45 (<italic>P</italic> = 0.002) were both significant parameters predicting clinical recurrence‐free survival. Otherwise, prostate‐specific antigen percent decline ≥ 0.45 was the only statistically significant predictor of biochemical failure‐free survival (biochemical failure‐free survival after salvage radiotherapy).</p> </sec> <sec id="iju12604-sec-0004" sec-type="section"> <title>Conclusions</title> <p>A prostate‐specific antigen value over 0.2 ng/mL at post‐salvage radiotherapy 4 months and prostate‐specific antigen percent decline ≥ 0.45 are negative predictors of clinical recurrence‐free survival after salvage radiotherapy. Prostate‐specific antigen percent decline ≥ 0.45 is also associated with worse biochemical failure‐free survival after salvage radiotherapy. Patients with delayed prostate‐specific antigen decrease should be carefully observed for clinical recurrence.</p> </sec> </abstract>