Effect of age and pathologic Gleason score on PSA recurrence: analysis of 2911 patients undergoing radical prostatectomy.

Journal Article (Journal Article)

OBJECTIVES: To clarify the relationship between age and pathologic Gleason score and their effect on prostate-specific antigen recurrence (PSAR). METHODS: The data from a cohort of 2911 men who had undergone radical prostatectomy from 1988 to 2006 were retrieved from the Duke Prostate Center database. Patient age was divided into 3 groups: <60, 60-64, and >or=65 years. The pathologic Gleason score was divided into 5 groups: 7. PSAR was defined as the prostate-specific antigen level increasing to >0.2 ng/mL >30 days after radical prostatectomy. The associations between age and pathologic Gleason score on PSAR and the time to PSAR were analyzed using parametric, nonparametric, Kaplan-Meier, and Cox regression techniques. RESULTS: Patient age and interval to PSAR had no significant association (P > .05). Kaplan-Meier analysis demonstrated a significant difference in PSAR among age groups. The pathologic Gleason scores of 3 + 3, 3 + 4, 4 + 3, and >7 were significant in determining the incidence of PSAR. Age was not significant for PSAR in patients with a pathologic Gleason score of 7, a statistically significant difference was observed among the age groups. Men <60 years old with a pathologic Gleason score >7 had a lower incidence of PSAR than did older men with a similar pathologic Gleason score. A pathologic Gleason score of >or=6 was significant in predicting PSAR. CONCLUSIONS: Age alone was an independent factor in predicting PSAR, but not in predicting the interval to PSAR. The pathologic Gleason score remained a predictor of PSAR, and patient age should be considered in patients with a pathologic Gleason score >7.

Full Text

Duke Authors

Cited Authors

  • Xu, DD; Sun, SD; Wang, F; Sun, L; Stackhouse, D; Polascik, T; Albala, DM; Moul, JW; Caire, A; Robertson, CN

Published Date

  • September 2009

Published In

Volume / Issue

  • 74 / 3

Start / End Page

  • 654 - 658

PubMed ID

  • 19628263

Pubmed Central ID

  • 19628263

Electronic International Standard Serial Number (EISSN)

  • 1527-9995

Digital Object Identifier (DOI)

  • 10.1016/j.urology.2008.12.063


  • eng

Conference Location

  • United States