PD63-04 DETECTABLE PROSTATE-SPECIFIC ANTIGEN VALUE BETWEEN 0.01 - 0.1NG/ML FOLLOWING ROBOTIC-ASSISTED RADICAL PROSTATECTOMY (RARP): DOES IT CORRELATE WITH FUTURE BIOCHEMICAL RECURRENCE?

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy V (PD63)1 Apr 2020PD63-04 DETECTABLE PROSTATE-SPECIFIC ANTIGEN VALUE BETWEEN 0.01 - 0.1NG/ML FOLLOWING ROBOTIC-ASSISTED RADICAL PROSTATECTOMY (RARP): DOES IT CORRELATE WITH FUTURE BIOCHEMICAL RECURRENCE? Ahmed Sayed Zakaria*, Amr Hodhod, Hanna Shahine, Félix Couture, Côme Tholomier, David-Dan Nguyen, Cristina Negrean, Kyle Law, Pierre Karakiewicz Karakiewicz, Assaad El-Hakim, and Kevin Zorn Ahmed Sayed Zakaria*Ahmed Sayed Zakaria* More articles by this author , Amr HodhodAmr Hodhod More articles by this author , Hanna ShahineHanna Shahine More articles by this author , Félix CoutureFélix Couture More articles by this author , Côme TholomierCôme Tholomier More articles by this author , David-Dan NguyenDavid-Dan Nguyen More articles by this author , Cristina NegreanCristina Negrean More articles by this author , Kyle LawKyle Law More articles by this author , Pierre Karakiewicz KarakiewiczPierre Karakiewicz Karakiewicz More articles by this author , Assaad El-HakimAssaad El-Hakim More articles by this author , and Kevin ZornKevin Zorn More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000980.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Ultrasensitive PSA assays is widely used in the early detection of biochemical recurrence (BCR) after RARP, setting a value of <0.01ng/ml rather than the regular value of <0.1ng/ml. Yet, the impact on future BCR of having a nadir and persistently detectable follow-up PSA between 0.01-0.1ng/ml, is still unclear. Our aim was to characterize PSA changes over time in this setting and to assess for further progression. METHODS: We conducted a retrospective review of 1359 men who underwent RARP in two high-volume centers, between 2006 and 2019. Patients were followed with PSA at 1,3,6,9,12,18,24,30 and 36 months then annually after. We included patients with PSA nadir value between 0.01-0.1ng/ml within 6 months of surgery and with at least 2 follow-up measurements within the same range. Within our cohort, we divided patients based on their BCR status and analyzed oncological outcomes and PSA evolution. Multi-variable Cox (MVC) hazard models were used to analyze variables predicting BCR-free survival (BCR-FS). RESULTS: 167 (12.3%) subjects were identified for analyses, with a mean follow-up time of 60.2 ±31.4 months (Table 1). In our cohort, 5-year BCR-FS rate was 86%, 32 (19.1%) patients had BCR, with a mean time to BCR of 43.7±24.3 months. Subsequently, 26 (15.5%) patients received salvage radiotherapy. During follow-up, BCR-free patients had stable mean PSA values ≤ 0.03 ng/ml while patients who developed BCR showed a slowly rising trend over time with a significant difference between groups starting at 9 months (P<0.023), even when values ≥ 0.10 ng/ml were excluded (Fig.1). In the MVC model, rising PSA (continuous) starting at 9 months was a significant predictor of BCR [(HR:2.7; 95%CI: 1.6-3.82) P=0.013]. CONCLUSIONS: Our study demonstrated that a considerable number of men have detectable PSA values ranging between 0.01-0.1ng/ml post-RARP. They can still be followed regularly to avoid patients’ anxiety and unnecessary radiotherapy. Close follow-up is still required. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1293-e1294 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ahmed Sayed Zakaria* More articles by this author Amr Hodhod More articles by this author Hanna Shahine More articles by this author Félix Couture More articles by this author Côme Tholomier More articles by this author David-Dan Nguyen More articles by this author Cristina Negrean More articles by this author Kyle Law More articles by this author Pierre Karakiewicz Karakiewicz More articles by this author Assaad El-Hakim More articles by this author Kevin Zorn More articles by this author Expand All Advertisement PDF downloadLoading ...