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Title: Is there a prostate-specific antigen upper limit for radical prostatectomy?
Authors: Gontero, Paulo ×
Spahn, Martin
Tombal, Bertrand
Bader, Pia
Hsu, Chao-Yu
Marchioro, Giansilvio
Frea, Bruno
Vander Eeckt, Kathy
Kneitz, Burkhard
Frohneberg, Detlef
Tizzani, Alessandro
Van Poppel, Hendrik
Joniau, Steven #
Issue Date: Oct-2011
Publisher: Blackwell Science
Series Title: BJU International vol:108 issue:7 pages:1093-1100
Article number: 10.1111/j.1464-410X.2011.10076.x
Abstract: OBJECTIVE: • To assess the feasibility of radical prostatectomy (RP) in a series of patients with prostate cancer with very high prostate-specific antigen (PSA) levels by comparing the clinical outcomes of different PSA thresholds (20.1-50 ng/mL, 50.1-100 ng/mL and >100 ng/mL, respectively).

PATIENTS AND METHODS: • Within a multicentre European retrospective database of 712 RP in patients with a baseline PSA level >20 ng/mL, we identified 48 patients with prostate cancer with a preoperative PSA level >100 ng/mL, 137 with a PSA level between 50.1 and 100 ng/mL and 527 with PSA values between 20.1 and 50 ng/mL. • Comparisons between groups were performed using chi-square test, analysis of variance and Kaplan-Meier analysis with log-rank test.

RESULTS: • Ten-year projected cancer-specific survival (79.8% in the PSA >100 ng/mL group vs 85.4% in the PSA 50.1-99 ng/mL group vs 90.9% in the PSA 20.1-50 ng/mL interval; P= 0.037) but not overall survival (59.6% in the PSA >100 ng/mL group vs 71.8% in the PSA 50.1-99 ng/mL group vs 75.3% in the PSA 20.1-50 ng/mL interval; P= 0.087) appeared significantly affected by the different PSA thresholds. • At a median follow-up of 78.7 months, 25.8%, 6.6% and 8.3% of patients in the PSA level groups for 20.1-50 ng/mL, 50.1-100 ng/mL and >100 ng/mL respectively, were cured by surgery alone.

CONCLUSIONS: • Ten-year cancer-specific survival, while showing significant reduction with increasing PSA values intervals, remain relatively high even for PSA levels >100 ng/mL. • As part of a multimodal treatment strategy, RP may therefore be an option, even in selected patients with prostate cancer whose PSA level is >100 ng/mL.
URI: 
ISSN: 1464-4096
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Urology Section (-)
× corresponding author
# (joint) last author

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