Timing of Prostate-specific Antigen Nadir After Radical Prostatectomy and Risk of Biochemical Recurrence.
Timing of Prostate-specific Antigen Nadir After Radical Prostatectomy and Risk of Biochemical Recurrence.
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DOI：
10.1016/j.urology.2017.07.009
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发表时间：
2017-10
期刊：
影响因子：
2.1
通讯作者：
Freedland SJ
中科院分区：
文献类型：
--
作者：
Skove SL;Howard LE;Aronson WJ;Terris MK;Kane CJ;Amling CL;Cooperberg MR;Moreira DM;Freedland SJ
评价PSA最低值水平和至最低值时间（TTN）之间的相关性，并在RESPONSE数据库中进行根治性乳腺癌切除术（RP）后生化复发（BCR）风险。回顾性分析了1998-2015年期间接受RP治疗的1，939名男性，在RP后1-6个月内获得超敏感PSA最低值。使用考克斯模型（根据人口统计学、肿瘤特征和术前PSA进行调整）对PSA最低值和TTN与从最低值至BCR的时间进行单因素和多因素分析。在PSA最低值不可检测的男性中，TTN与BCR无关（1-2.9 vs. 3-6个月：HR 0.86，p=0.46）。无论TTN如何，可检测到最低点的男性BCR风险增加（TTN 3-6个月：HR 1.81，p=0.024; TTN 1-2.99个月：HR 3.75，p<0.001 vs.不可检测的最低点和TTN 3-6个月）。在1-3个月时可检测到PSA的男性中，53%在RP后3-6个月的随访PSA较低，32%无法检测到，21%较低但仍可检测到。在RP后设置中，具有可检测的最低点和较短TTN的男性具有增加的BCR风险。有趣的是，在RP后的前3个月内可检测到PSA的男性中，约有一半在RP后3至6个月内的随访PSA较低。如果在未来的研究中得到证实，这对考虑根据RP后前3个月的术后PSA值进行辅助治疗的患者具有重要意义。
To evaluate the association between PSA nadir level and time to nadir (TTN) with biochemical recurrence (BCR) risk after radical prostatectomy (RP) in the SEARCH database. Retrospective analysis of 1,939 men from the SEARCH database treated with RP between 1998–2015 with available ultrasensitive PSA nadir within 1–6 months after RP. Uni- and multivariable analyses of PSA nadir and TTN with time from nadir to BCR were done with Cox models (adjusted for demographics, tumor features and preoperative PSA). Among men with an undetectable PSA nadir, the TTN was unrelated to BCR (1–2.9 vs. 3–6 months: HR 0.86, p=0.46). Regardless of TTN, men with detectable nadir had increased risk of BCR (TTN 3–6 months: HR 1.81, p=0.024; TTN 1–2.99 months: HR 3.75, p<0.001 vs. undetectable nadir and TTN 3–6 months). Among men with a detectable PSA at 1–3 months, 53% had a lower follow-up PSA 3–6 months after RP which was undetectable in 32% and lower but still detectable in 21%. In the post-RP setting, men with both a detectable nadir and a shorter TTN had an increased risk of BCR. Intriguingly, about half of the men with a detectable PSA in the first 3 months after RP had a lower follow-up PSA between 3 and 6 months after RP. If confirmed in future studies, this has important implications for patients considering adjuvant therapy based upon post-operative PSA values in the first 3 months after RP.
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影响因子：
3.4
作者：
Vesely, Stepan;Jarolim, Ladislav;Babjuk, Marko
通讯作者：
Babjuk, Marko
影响因子：
23.4
作者：
Keto, Christopher J.;Aronson, William J.;Terris, Martha K.;Presti, Joseph C.;Kane, Christopher J.;Amling, Christopher L.;Freedland, Stephen J.
通讯作者：
Freedland, Stephen J.
影响因子：
2.1
作者：
Chung, Christine S.;Chen, Ming-Hui;D'Amico, Anthony V.
通讯作者：
D'Amico, Anthony V.
影响因子：
6.6
作者：
Moreira, Daniel M.;Presti, Joseph C., Jr.;Freedland, Stephen J.
通讯作者：
Freedland, Stephen J.
影响因子：
6.2
作者：
Rogers, CG;Khan, MA;Partin, AW
通讯作者：
Partin, AW