Ultrasensitive prostate‐specific antigen level as a predictor of biochemical progression after robot‐assisted radical prostatectomy: Towards risk adapted follow‐up. Issue 2 (26th October 2018)

• Record Type: Journal Article
• Authors: Grivas, Nikolaos; de Bruin, Daan; Barwari, Kurdo; van Muilekom, Erik; Tillier, Corinne; van Leeuwen, Pim J.; Wit, Esther; Kroese, Wouter; van der Poel, Henk
• Is Part Of: Journal of clinical laboratory analysis. Volume 33:Issue 2(2019)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2018-10-26
• Subjects: biochemical recurrence -- predictive value of tests -- prostatectomy -- prostate‐specific antigen; Diagnosis, Laboratory -- Periodicals; Medical laboratory technology -- Periodicals; 616
• DOI: 10.1002/jcla.22693
• Languages: English
• ISSNs: 0887-8013

Abstract

Abstract : 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.