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First postoperative PSA is associated with outcomes in patients with node positive prostate cancer: Results from the SEARCH database.

Publication ,  Journal Article
McDonald, ML; Howard, LE; Aronson, WJ; Terris, MK; Cooperberg, MR; Amling, CL; Freedland, SJ; Kane, CJ
Published in: Urologic oncology
May 2018

To analyze factors associated with metastases, prostate cancer-specific mortality, and all-cause mortality in pN1 patients.We analyzed 3,642 radical prostatectomy patients within the Shared Equal Access Regional Cancer Hospital (SEARCH) database. Pathologic Gleason grade, number of lymph nodes (LN) removed, and first postoperative prostate-specific antigen (PSA) (<0.2 ng/ml or ≥0.2 ng/ml) were among covariates assessed. Cox regression was used to analyze the association between characteristics and survival outcomes. Kaplan-Meier was used to estimate survival in pN1 patients stratified by first postoperative PSA.Of 3,642 patients, 124 (3.4%) had pN1. There were 71 (60%) patients with 1 positive LN, 32 (27%) with 2 positive LNs, and 15 (13%) with ≥3. Among men with pN1, first postoperative PSA was<0.2ng/ml in 46 patients (51%) and ≥0.2ng/ml in 44 patients (49%). Univariable Cox regression determined pathological Gleason grade (P = 0.021), seminal vesicle invasion (P = 0.010), and first postoperative PSA ≥0.2 ng/ml (P = 0.005) were associated with metastases. First postoperative PSA ≥0.2ng/ml was associated with metastasis on multivariable analysis (P = 0.046). Log-rank analysis revealed a more favorable metastases-free survival in patients with a first postoperative PSA<0.2ng/ml (P = 0.001). Estimated 5-year metastases-free survival rate was 99% for patients with a first postoperative PSA<0.2ng/ml and 87% for ≥0.2ng/ml.pN1 patients with a first postoperative PSA ≥0.2ng/ml were more likely to develop metastases. First postoperative PSA may be useful in identifying pN1 patients who harbor distant disease and aid in secondary treatment decisions.

Duke Scholars

Published In

Urologic oncology

DOI

EISSN

1873-2496

ISSN

1078-1439

Publication Date

May 2018

Volume

36

Issue

5

Start / End Page

239.e17 / 239.e25

Related Subject Headings

  • Urology & Nephrology
  • Survival Rate
  • Retrospective Studies
  • Prostatic Neoplasms
  • Prostatectomy
  • Prostate-Specific Antigen
  • Postoperative Complications
  • Neoplasm Invasiveness
  • Neoplasm Grading
  • Middle Aged
 

Citation

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McDonald, M. L., Howard, L. E., Aronson, W. J., Terris, M. K., Cooperberg, M. R., Amling, C. L., … Kane, C. J. (2018). First postoperative PSA is associated with outcomes in patients with node positive prostate cancer: Results from the SEARCH database. Urologic Oncology, 36(5), 239.e17-239.e25. https://doi.org/10.1016/j.urolonc.2018.01.005
McDonald, Michelle L., Lauren E. Howard, William J. Aronson, Martha K. Terris, Matthew R. Cooperberg, Christopher L. Amling, Stephen J. Freedland, and Christopher J. Kane. “First postoperative PSA is associated with outcomes in patients with node positive prostate cancer: Results from the SEARCH database.Urologic Oncology 36, no. 5 (May 2018): 239.e17-239.e25. https://doi.org/10.1016/j.urolonc.2018.01.005.
McDonald ML, Howard LE, Aronson WJ, Terris MK, Cooperberg MR, Amling CL, et al. First postoperative PSA is associated with outcomes in patients with node positive prostate cancer: Results from the SEARCH database. Urologic oncology. 2018 May;36(5):239.e17-239.e25.
McDonald, Michelle L., et al. “First postoperative PSA is associated with outcomes in patients with node positive prostate cancer: Results from the SEARCH database.Urologic Oncology, vol. 36, no. 5, May 2018, pp. 239.e17-239.e25. Epmc, doi:10.1016/j.urolonc.2018.01.005.
McDonald ML, Howard LE, Aronson WJ, Terris MK, Cooperberg MR, Amling CL, Freedland SJ, Kane CJ. First postoperative PSA is associated with outcomes in patients with node positive prostate cancer: Results from the SEARCH database. Urologic oncology. 2018 May;36(5):239.e17-239.e25.
Journal cover image

Published In

Urologic oncology

DOI

EISSN

1873-2496

ISSN

1078-1439

Publication Date

May 2018

Volume

36

Issue

5

Start / End Page

239.e17 / 239.e25

Related Subject Headings

  • Urology & Nephrology
  • Survival Rate
  • Retrospective Studies
  • Prostatic Neoplasms
  • Prostatectomy
  • Prostate-Specific Antigen
  • Postoperative Complications
  • Neoplasm Invasiveness
  • Neoplasm Grading
  • Middle Aged