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Japanese Journal of Clinical Oncology 32:536-542 (2002)
© 2002 Foundation for Promotion of Cancer Research

Predicting Prostate Specific Antigen Failure after Radical Retropubic Prostatectomy for T1c Prostate Cancer

Yen-Chuan Ou1,2, Jung-Ta Chen2,3, Chi-Rei Yang1,2, Chen-Li Cheng1, Hao-Chung Ho1, Jiunn-Liang Ko4 and Yih-Shou Hsieh5,+

1 Division of Urology, Department of Surgery, 3 Department of Pathology, Taichung Veterans General Hospital, National Yang-Ming University School of Medicine, Taiwan, 2 Institute of Medicine, 4 Institute of Toxicology and 5 Institute of Biochemistry, Chung Shan Medical University, Taiwan

Purpose: Clinicopathological data were reviewed to find a predictor of prostate specific antigen (PSA) failure in Taiwanese patients who had received radical retropubic prostatectomy (RRP) for stage T1c prostate cancer (PC).

Methods: Fifty-five consecutive men who underwent RRP for stage T1c PC were included. The clinical end point was PSA failure (PSA >0.2 ng/ml). Preoperative PSA, free-to-total PSA ratio, prostate volume, PSA density, transrectal sextant biopsy and whole mount of RRP parameters were analyzed for their ability to predict postoperative PSA failure.

Results: Fifteen of the 55 patients developed PSA failure during the follow-up period. Those with PSA failure had higher PSA, higher percentage of cancer in biopsies and higher biopsy Gleason score than the freedom from PSA failure group (all P < 0.05). The PSA failure group had higher pathology Gleason score and a higher incidence of extracapsular tumor extension than the freedom from PSA failure group (all P < 0.05). The PSA failure group had a larger tumor volume and higher incidence of combined peripheral lobe with transitional lobe involvement than the freedom from PSA failure group (all P < 0.05). Multivariate analysis revealed that the predictors for PSA failure after RRP were biopsy Gleason score >=6, tumor volume >=2.5 ml and PSA >=10 ng/ml.

Conclusion: The single most significant predictor for PSA failure in T1c PC patients after RRP was tumor volume >=2.5 ml.

+ For reprints and all correspondence: Chi-Rei Yang, 160, Sect. 3, Taichung-Kang Road, Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung 40705, Taiwan. E-mail: ycou@vghtc.vghtc.gov.tw


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