Abstract

RODRIGUEZ-ALONSO, A. et al. Relationship of preoperative PSA velocity to histopathological findings in the surgical specimen and survival after radical prostatectomy. Actas Urol Esp [online]. 2010, vol.34, n.5, pp.417-427. ISSN 0210-4806.

Objective: To assess whether PSA velocity (PSV) is related to pathological findings in surgical specimen, biochemical recurrence-free survival (BRFS), cancer-related survival (CRS), and overall survival (OS). Materials and methods: A retrospective and prospective observational cohort study on 265 patients with prostate cancer (PCa) who underwent radical prostatectomy (RP) from 2000 to 2008. PSAV was calculated arithmetically and by linear regression analysis, using PSA values in the year prior to diagnosis. A multivariate logistic regression analysis was performed to detect variables associated to extracapsular disease (ECD). Variables related to BRFS, CRS, and OS were analyzed using Kaplan-Meier methodology (PSAV <3 vs. >3ng/mL/year) and a multivariate Cox regression analysis. The ability of PSA velociy to predict BRFS, CRS, and OS was evaluated by c-index. Results: Median follow-up was 56.16 months (9.14-106.75). Median PSAV was 0.65 and 0.63ng/ml/year using the arithmetic and regression methods respectively. ECD was detected in 74 specimens (27.92%), and biochemical recurrence in 50 patients (18.87%). Cancer-related mortality was seen in 4 patients (1.52%) and overall mortality in 16 (6.08%). In the multivariate analysis, PSAV was not related to ECD. PSAV was an independent predictor for BRFS (RR: 1.06, 95% CI: 1.02-1.13, p=0.008), CRS (RR: 1.22, 95% CI: 1.00-1.50, p=0.048), and OS (RR: 1.35, 95% CI: 1.18-1.55, p<0.001) in the multivariate Cox regression analysis. Conclusions: PSAV is a preoperative parameter that predicts for BFRS, CRS, and OS in patients undergoing RP. No association was found between PSA velocity and presence of ECD.

Keywords : Prostatic neoplasms; Radical prostatectomy; PSA velocity; Biochemical recurrence; Extracapsular disease; Survival.

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