Relapse and cure rates of prostate cancer patients after radical prostatectomy and 5 years of follow-up

Vassilikos, Evyenia J.K.; Yu, He; Trachtenberg, John; Nam, Robert K.; Narod, Steven A.; Bromberg, Irving L.; Diamandis, Eleftherios P.

doi:10.1016/s0009-9120(99)00099-5

Cited by 26 publications

(21 citation statements)

References 35 publications

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“…15,19,22,27,30 Assays with a relatively low cutoff of 0.008 and 0.02 ng/ml were associated with a low PPV of 37% and 30%, respectively. 15,27 Instead of using a single cutoff integrating PSA kinetics into the BCR definition resulted in an 86% PPV despite a low LLD of 0.001 ng/ml.…”

Section: Bcr Diagnosis Lead Timementioning

confidence: 93%

“…22 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276 277 278 279 280 281 282 283 284 285 286 287 288 289 290 291 292 293 294 295 296 297 298 299 300 301 302 303 304 305 306 307 308 309 310 311 312 313 314 315 316 317 318 319 320 321 322 323 324 325 326 327 328 329 330 331 332 333 334 335 336 337 338 339 340 341 342 Several groups defined a subset of patients in whom uPSA reached a detectable or a certain predefined level but never attained a level traditionally defined as BCR within a median of 15 to more than 85 months (table 4 ½T4 ). 15,19,22,2...…”

Section: Bcr Diagnosis Lead Timementioning

confidence: 99%

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Ultrasensitive Prostate Specific Antigen and its Role after Radical Prostatectomy: A Systematic Review

Tilki

Kim

et al. 2015

Journal of Urology

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Ultrasensitive prostate specific antigen is useful in the early diagnosis of cancer recurrence after radical prostatectomy but specificity is poor. To date there is a lack of evidence that earlier detection of recurrence translates into prolonged time to metastasis. Integrating ultrasensitive prostate specific antigen with other clinicopathological factors can help determine optimal adjuvant and salvage therapy.

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Section: Bcr Diagnosis Lead Timementioning

confidence: 93%

Section: Bcr Diagnosis Lead Timementioning

confidence: 99%

Ultrasensitive Prostate Specific Antigen and its Role after Radical Prostatectomy: A Systematic Review

Tilki

Kim

et al. 2015

Journal of Urology

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“…Third-generation PSA assays that detect serum PSA concentrations Ն10 ng/L (Ն0.01 g/L) have proved useful for predicting subgroups of patients more and less likely to exhibit BCR several months or years earlier (11)(12)(13)(14)(15)(16)(17)(18)(19). At these low levels, however, dayto-day reproducibility in the laboratory appears to limit their usefulness for accurately quantitating changes in PSA concentrations over time.…”

Section: Discussionmentioning

confidence: 99%

“…In comparison to conventional assays with detection limits of 100 ng/L or higher, more sensitive assays can detect biochemical recurrence (BCR) several months or years earlier (11)(12)(13)(14)(15)(16)(17)(18)(19). Investigational PSA assays with greater sensitivity show that serum PSA in some postprostatectomy patients drops below 1 ng/L, a concentration that could be accurately quantified only by use of more sensitive (fourth-or fifth-generation) PSA assays (20,21 ).…”

mentioning

confidence: 99%

Nucleic Acid Detection Immunoassay for Prostate-Specific Antigen Based on Immuno-PCR Methodology

McDermed¹,

Sanders²,

Fait³

et al. 2012

Clinical Chemistry

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BACKGROUND: Serum prostate-specific antigen (PSA) concentrations after radical prostatectomy typically become undetectable with the use of current immunometric assay methods. Despite modern surgical techniques, 15%-30% of prostate cancer patients undergoing radical prostatectomy develop a biochemical recurrence during follow-up. Unfortunately, poor analytical sensitivity of standard PSA assays delays biochemical recurrence detection, and because of day-today assay imprecision ultrasensitive PSA assays cannot assess PSA kinetics. We developed an immuno-PCR assay for total PSA that has a limit of quantification Ͼ10 times lower than current ultrasensitive assays.

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“…It allows for earlier detection of biochemical relapse by around 11-18 months over traditional methods. 11,16 Defining biochemical relapse in uPSA-monitored patients is still debated. Some authors feel there is too much 'background noise' at the very lowest levels to make this technique specific enough.…”

Section: Discussionmentioning

confidence: 99%

Ultrasensitive Prostate Specific Antigen Assay Following Laparoscopic Radical Prostatectomy – An Outcome Measure for Defining the Learning Curve

Viney

Gommersall

Zeif

et al. 2009

annals

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Ann R Coll Surg EnglRadical retropubic prostatectomy (RRP) performed laparoscopically is a popular treatment with curative intent for organ-confined prostate cancer. After surgery, prostate specific antigen (PSA) levels drop to low levels which can be measured with ultrasensitive assays. This has been described in the literature for open RRP but not for laparoscopic RRP. This paper describes PSA changes in the first 300 consecutive patients undergoing non-robotic laparoscopic RRP by a single surgeon. OBJECTIVES To use ultrasensitive PSA (uPSA) assays to measure a PSA nadir in patients having laparoscopic radical prostatectomy below levels recorded by standard assays. The aim was to use uPSA nadir at 3 months' post-prostatectomy as an early surrogate end-point of oncological outcome. In so doing, laparoscopic oncological outcomes could then be compared with published results from other open radical prostatectomy series with similar end-points. Furthermore, this end-point could be used in the assessment of the surgeon's learning curve. PATIENTS AND METHODS Prospective, comprehensive, demographic, clinical, biochemical and operative data were collected from all patients undergoing non-robotic laparoscopic RRP. We present data from the first 300 consecutive patients undergoing laparoscopic RRP by a single surgeon. uPSA was measured every 3 months post surgery. RESULTS Median follow-up was 29 months (minimum 3 months). The likelihood of reaching a uPSA of ≤ 0.01 ng/ml at 3 months is 73% for the first 100 patients. This is statistically lower when compared with 83% (P < 0.05) for the second 100 patients and 80% for the third 100 patients (P < 0.05). Overall, 84% of patients with pT2 disease and 66% patients with pT3 disease had a uPSA of ≤ 0.01 ng/ml at 3 months. Pre-operative PSA, PSA density and Gleason score were not correlated with outcome as determined by a uPSA of ≤ 0.01 ng/ml at 3 months. Positive margins correlate with outcome as determined by a uPSA of ≤ 0.01 ng/ml at 3 months but operative time and tumour volume do not (P < 0.05). Attempt at nerve sparing had no adverse effect on achieving a uPSA of ≤ 0.01 ng/ml at 3 months. CONCLUSIONS uPSA can be used as an early end-point in the analysis of oncological outcomes after radical prostatectomy. It is one of many measures that can be used in calculating a surgeon's learning curve for laparoscopic radical prostatectomy and in bench-marking performance. With experience, a surgeon can achieve in excess of an 80% chance of obtaining a uPSA nadir of ≤ 0.01 ng/ml at 3 months after laparoscopic RRP for a British population. This is equivalent to most published open series.

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Relapse and cure rates of prostate cancer patients after radical prostatectomy and 5 years of follow-up

Cited by 26 publications

References 35 publications

Ultrasensitive Prostate Specific Antigen and its Role after Radical Prostatectomy: A Systematic Review

Ultrasensitive Prostate Specific Antigen and its Role after Radical Prostatectomy: A Systematic Review

Nucleic Acid Detection Immunoassay for Prostate-Specific Antigen Based on Immuno-PCR Methodology

Ultrasensitive Prostate Specific Antigen Assay Following Laparoscopic Radical Prostatectomy – An Outcome Measure for Defining the Learning Curve

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