Prostate Specific Antigen Testing after Radical Prostatectomy—Can We Stop at 20 Years?
| Autor: | Wesley W. Ludwig, Zhaoyong Feng, Patrick C. Walsh, Elizabeth B. Humphreys, Bruce J. Trock |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Subset Analysis Biochemical recurrence Oncology medicine.medical_specialty Time Factors Urology medicine.medical_treatment 030232 urology & nephrology Disease-Free Survival Metastasis 03 medical and health sciences Prostate cancer 0302 clinical medicine Internal medicine Humans Medicine Cumulative incidence Stage (cooking) Neoplasm Staging Aged 80 and over Prostatectomy business.industry Prostatic Neoplasms food and beverages Middle Aged Prostate-Specific Antigen medicine.disease Prostate-specific antigen 030220 oncology & carcinogenesis Neoplasm Recurrence Local business |
| Zdroj: | Journal of Urology. 199:114-119 |
| ISSN: | 1527-3792 0022-5347 |
| DOI: | 10.1016/j.juro.2017.08.041 |
| Popis: | We examined the clinical features and outcomes associated with delayed biochemical recurrence after radical prostatectomy, specifically among men with more than 20 years of followup.A total of 16,720 men underwent radical prostatectomy and 2,699 experienced biochemical recurrence. We determined predictors of delayed biochemical recurrence as well as metastasis-free and cancer specific survival rates for recurrence at various time points after radical prostatectomy. We performed subset analysis of the 732 men with 20 or more years of recurrence-free followup. Cumulative incidence curves for metastasis and prostate cancer death were calculated and stratified by biochemical recurrence time points.Predictors of delayed biochemical recurrence included elevated prostate specific antigen at radical prostatectomy, higher clinical and pathological stage, and positive surgical margins. Delayed biochemical recurrence was associated with favorable cumulative incidence curves for metastasis and prostate cancer death compared to early biochemical recurrence. Among the 732 men with undetectable prostate specific antigen at 20 years biochemical recurrence developed in 17 (2.3%), metastatic disease developed in a single patient and none died of prostate cancer. The actuarial probability of biochemical recurrence among men with undetectable prostate specific antigen at 20 years increased with adverse pathological features.Men with delayed biochemical recurrence have favorable clinical features and improved survival. Men with undetectable prostate specific antigen 20 years after radical prostatectomy had a low rate of recurrence and no deaths from prostate cancer. This suggests that 20 years is a reasonable time to discontinue prostate specific antigen testing. |
| Databáze: | OpenAIRE |
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