Does PSADT After Radical Prostatectomy Correlate With Overall Survival?—A Report From the SEARCH Database Group - 20/08/11
Reprint requests: Stephen J. Freedland, M.D., Division of Urologic Surgery and Duke Prostate Center, Departments of Surgery and Pathology, Box 2626, Duke University Medical Center, Durham, NC 27710Résumé |
Objectives |
To examine the correlation between the prostate-specific antigen doubling time (PSADT) and overall survival (OS) and among men in the SEARCH database (an older, racially diverse cohort undergoing RP at multiple Veterans Affairs medical centers). Previous studies largely performed at tertiary care centers with relatively young, racially homogenous cohorts found a short PSADT on recurrence after RP portended a poor prognosis.
Methods |
We performed a Cox proportional hazards analysis to examine the correlation between postrecurrence PSADT and the interval from recurrence to OS and prostate cancer-specific mortality among 345 men in the SEARCH database who had undergone RP from 1988 to 2008. We examined the PSADT as a categorical variable using the clinically significant cutpoints of <3, 3-8.9, 9-14.9, and ≥15 months.
Results |
A PSADT of <3 months (hazard ratio 5.48, P = .002) was associated with poorer OS than a PSADT of ≥15 months. A trend was seen toward worse OS for the men with a PSADT of 3-8.9 months (hazard ratio 1.70, P = .07). PSADTs of <3 months (P < .001) and 3-8.9 months (P = .004) were associated with an increased risk of prostate cancer-specific mortality.
Conclusions |
In an older, racially diverse cohort, recurrence with a PSADT of <9 months was associated with worse all-cause mortality. The results of the present study have validated previous findings that PSADT is a useful tool for identifying men at increased risk of all-cause mortality early in their disease course.
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| This study was supported by the Department of Veterans Affairs, Department of Defense, National Institutes of Health, Georgia Cancer Coalition, American Urological Association Foundation/Astellas Rising Star in Urology Award, and Duke University's CTSA grant UL1RR024128 (NCRR/National Institutes of Health). |
Vol 77 - N° 1
P. 149-153 - janvier 2011 Retour au numéro
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