MP57-19 VALIDATION OF PROSTATE SPECIFIC ANTIGEN DOUBLING TIME KINETICS FOLLOWING RADICAL PROSTATECTOMY TO GUIDE ACTIVE OBSERVATION AND INTERVENTION

Abstract

You have accessJournal of UrologyCME1 May 2022MP57-19 VALIDATION OF PROSTATE SPECIFIC ANTIGEN DOUBLING TIME KINETICS FOLLOWING RADICAL PROSTATECTOMY TO GUIDE ACTIVE OBSERVATION AND INTERVENTION Erica Huang, Linda My Huynh, Adam Gordon, Ryan Chandhoke, Blanca Morales, Douglas Skarecky, Joshua Tran, and Thomas Ahlering Erica HuangErica Huang More articles by this author , Linda My HuynhLinda My Huynh More articles by this author , Adam GordonAdam Gordon More articles by this author , Ryan ChandhokeRyan Chandhoke More articles by this author , Blanca MoralesBlanca Morales More articles by this author , Douglas SkareckyDouglas Skarecky More articles by this author , Joshua TranJoshua Tran More articles by this author , and Thomas AhleringThomas Ahlering More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002640.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Biochemical recurrence (BCR) following radical prostatectomy (RP) has limited ability to predict metastatic progression or prostate cancer specific mortality (PCSM). In our experience, a significant number of men with BCR have non-lethal BCR that can be safely observed based on PSA doubling time (DT) and subsequent DT change without radiation (RT) and/or androgen deprivation therapy (ADT). The present study seeks to validate the use of DT kinetics to direct active observation (AO) and intervention. METHODS: A retrospective cohort analysis of 1864 men who underwent RP between June 2002 and September 2019 was conducted. Patients were assessed for treatment intervention (RT and/or ADT) versus AO with DT kinetics. Our main outcome was the predictive value of multivariate regression models for no treatment via ROC analysis. Secondary outcomes were PCSM via Kaplan-Meier analysis. RESULTS: 407/1864 (21.8%) men experienced BCR (PSA >0.2 ng/dl, x2), with median follow-up of 7.6 years (IQR 3.3-11.9) (Table 1). In multivariable analysis, DT >12 months (OR: 8.93, 95%CI: 4.53, 17.6) and increasing DT (OR: 5.49, 95%CI: 2.81, 10.71) were significant predictors for continued observation without treatment (p <0.001), while pGGG, p-stage, age, and preoperative PSA were not. This model was an excellent predictor for continued no treatment (AUC=0.83). No patients with DT >12 months, increasing DT experienced PCSM (Figure 1). CONCLUSIONS: In our experience, one third of patients with BCR were observed without RT and/or ADT, with 0% PCSM at mean 7.6 years follow-up. DT >12 months and increasing DT were excellent predictors of no need for treatment. We introduce PSA kinetics as a means for guiding need and/or no need for treatment intervention. Source of Funding: N/A © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e989 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Erica Huang More articles by this author Linda My Huynh More articles by this author Adam Gordon More articles by this author Ryan Chandhoke More articles by this author Blanca Morales More articles by this author Douglas Skarecky More articles by this author Joshua Tran More articles by this author Thomas Ahlering More articles by this author Expand All Advertisement PDF DownloadLoading ...