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The impact of very high initial PSA on oncological outcomes after radical prostatectomy for clinically localized prostate cancer

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The impact of very high initial PSA on oncological outcomes after radical prostatectomy for clinically localized prostate cancer. / Tilki, Derya; Mandel, Philipp; Karakiewicz, Pierre I; Heinze, Alexander; Huland, Hartwig; Graefen, Markus; Knipper, Sophie.

In: UROL ONCOL-SEMIN ORI, Vol. 38, No. 5, 05.2020, p. 379-385.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Tilki, D, Mandel, P, Karakiewicz, PI, Heinze, A, Huland, H, Graefen, M & Knipper, S 2020, 'The impact of very high initial PSA on oncological outcomes after radical prostatectomy for clinically localized prostate cancer', UROL ONCOL-SEMIN ORI, vol. 38, no. 5, pp. 379-385. https://doi.org/10.1016/j.urolonc.2019.12.027

APA

Tilki, D., Mandel, P., Karakiewicz, P. I., Heinze, A., Huland, H., Graefen, M., & Knipper, S. (2020). The impact of very high initial PSA on oncological outcomes after radical prostatectomy for clinically localized prostate cancer. UROL ONCOL-SEMIN ORI, 38(5), 379-385. https://doi.org/10.1016/j.urolonc.2019.12.027

Vancouver

Tilki D, Mandel P, Karakiewicz PI, Heinze A, Huland H, Graefen M et al. The impact of very high initial PSA on oncological outcomes after radical prostatectomy for clinically localized prostate cancer. UROL ONCOL-SEMIN ORI. 2020 May;38(5):379-385. https://doi.org/10.1016/j.urolonc.2019.12.027

Bibtex

@article{2ecc296f718f493e95d583a2b27b6263,
title = "The impact of very high initial PSA on oncological outcomes after radical prostatectomy for clinically localized prostate cancer",
abstract = "BACKGROUND: To analyze oncological outcomes of very high-risk patients with initial PSA 50-99.9 and ≥100 ng/ml who underwent radical prostatectomy (RP) for clinically localized prostate cancer.METHODS: Overall, 2,811 RP patients (1992-2018) with negative preoperative CT-scan and bone scintigraphy were included. The impact of preoperative PSA level, categorized as 20-49.9 (n = 2,195) vs. 50-99.9 (n = 454) vs. ≥100 ng/ml (n = 162) on biochemical recurrence (BCR)-free survival, metastasis-free survival (MFS) and cancer-specific survival (CSS) was assessed using Kaplan-Meier and multivariable Cox regression models.RESULTS: Median follow-up was 47.5 months. Ten-year BCR-free survival rates were 46.9 vs. 32.1 vs. 29.0% within PSA-categories 20-49.9 vs. 50-99.9 vs. ≥100 ng/ml, respectively (P < 0.001). Ten-year MFS rates were 78.4 vs. 67.2 vs. 37.3% within PSA-categories 20-49.9 vs. 50-99.9 vs. ≥100 ng/ml (P < 0.001). 10-year CSS rates were 93.7 vs. 85.5 vs. 66.7% within PSA-categories 20-49.9 vs. 50-99.9 vs. ≥100 ng/ml (P < 0.001). In multivariable analyses, PSA-categories 50-99.9 ng/ml and ≥100 ng/ml were independently predicting higher risk of BCR (hazard ratio [HR]: 1.3 and 1.4), metastatic progression (HR: 1.4 and 2.3), and cancer-specific mortality (CSM, HR: 1.9 and 3.4) compared with PSA-category 20-49.9 ng/ml.CONCLUSION: Initial PSA levels ≥50 ng/ml are associated with higher risk of BCR, metastatic progression, and CSM compared with high-risk patients with PSA of 20-49.9 ng/ml. In consequence, these patients may be counseled about a potentially increased risk of undetected metastases prior to RP possibly necessitating intensified multimodal treatments in the future.",
author = "Derya Tilki and Philipp Mandel and Karakiewicz, {Pierre I} and Alexander Heinze and Hartwig Huland and Markus Graefen and Sophie Knipper",
note = "Copyright {\textcopyright} 2020 Elsevier Inc. All rights reserved.",
year = "2020",
month = may,
doi = "10.1016/j.urolonc.2019.12.027",
language = "English",
volume = "38",
pages = "379--385",
journal = "UROL ONCOL-SEMIN ORI",
issn = "1078-1439",
publisher = "Elsevier Inc.",
number = "5",

}

RIS

TY - JOUR

T1 - The impact of very high initial PSA on oncological outcomes after radical prostatectomy for clinically localized prostate cancer

AU - Tilki, Derya

AU - Mandel, Philipp

AU - Karakiewicz, Pierre I

AU - Heinze, Alexander

AU - Huland, Hartwig

AU - Graefen, Markus

AU - Knipper, Sophie

N1 - Copyright © 2020 Elsevier Inc. All rights reserved.

PY - 2020/5

Y1 - 2020/5

N2 - BACKGROUND: To analyze oncological outcomes of very high-risk patients with initial PSA 50-99.9 and ≥100 ng/ml who underwent radical prostatectomy (RP) for clinically localized prostate cancer.METHODS: Overall, 2,811 RP patients (1992-2018) with negative preoperative CT-scan and bone scintigraphy were included. The impact of preoperative PSA level, categorized as 20-49.9 (n = 2,195) vs. 50-99.9 (n = 454) vs. ≥100 ng/ml (n = 162) on biochemical recurrence (BCR)-free survival, metastasis-free survival (MFS) and cancer-specific survival (CSS) was assessed using Kaplan-Meier and multivariable Cox regression models.RESULTS: Median follow-up was 47.5 months. Ten-year BCR-free survival rates were 46.9 vs. 32.1 vs. 29.0% within PSA-categories 20-49.9 vs. 50-99.9 vs. ≥100 ng/ml, respectively (P < 0.001). Ten-year MFS rates were 78.4 vs. 67.2 vs. 37.3% within PSA-categories 20-49.9 vs. 50-99.9 vs. ≥100 ng/ml (P < 0.001). 10-year CSS rates were 93.7 vs. 85.5 vs. 66.7% within PSA-categories 20-49.9 vs. 50-99.9 vs. ≥100 ng/ml (P < 0.001). In multivariable analyses, PSA-categories 50-99.9 ng/ml and ≥100 ng/ml were independently predicting higher risk of BCR (hazard ratio [HR]: 1.3 and 1.4), metastatic progression (HR: 1.4 and 2.3), and cancer-specific mortality (CSM, HR: 1.9 and 3.4) compared with PSA-category 20-49.9 ng/ml.CONCLUSION: Initial PSA levels ≥50 ng/ml are associated with higher risk of BCR, metastatic progression, and CSM compared with high-risk patients with PSA of 20-49.9 ng/ml. In consequence, these patients may be counseled about a potentially increased risk of undetected metastases prior to RP possibly necessitating intensified multimodal treatments in the future.

AB - BACKGROUND: To analyze oncological outcomes of very high-risk patients with initial PSA 50-99.9 and ≥100 ng/ml who underwent radical prostatectomy (RP) for clinically localized prostate cancer.METHODS: Overall, 2,811 RP patients (1992-2018) with negative preoperative CT-scan and bone scintigraphy were included. The impact of preoperative PSA level, categorized as 20-49.9 (n = 2,195) vs. 50-99.9 (n = 454) vs. ≥100 ng/ml (n = 162) on biochemical recurrence (BCR)-free survival, metastasis-free survival (MFS) and cancer-specific survival (CSS) was assessed using Kaplan-Meier and multivariable Cox regression models.RESULTS: Median follow-up was 47.5 months. Ten-year BCR-free survival rates were 46.9 vs. 32.1 vs. 29.0% within PSA-categories 20-49.9 vs. 50-99.9 vs. ≥100 ng/ml, respectively (P < 0.001). Ten-year MFS rates were 78.4 vs. 67.2 vs. 37.3% within PSA-categories 20-49.9 vs. 50-99.9 vs. ≥100 ng/ml (P < 0.001). 10-year CSS rates were 93.7 vs. 85.5 vs. 66.7% within PSA-categories 20-49.9 vs. 50-99.9 vs. ≥100 ng/ml (P < 0.001). In multivariable analyses, PSA-categories 50-99.9 ng/ml and ≥100 ng/ml were independently predicting higher risk of BCR (hazard ratio [HR]: 1.3 and 1.4), metastatic progression (HR: 1.4 and 2.3), and cancer-specific mortality (CSM, HR: 1.9 and 3.4) compared with PSA-category 20-49.9 ng/ml.CONCLUSION: Initial PSA levels ≥50 ng/ml are associated with higher risk of BCR, metastatic progression, and CSM compared with high-risk patients with PSA of 20-49.9 ng/ml. In consequence, these patients may be counseled about a potentially increased risk of undetected metastases prior to RP possibly necessitating intensified multimodal treatments in the future.

U2 - 10.1016/j.urolonc.2019.12.027

DO - 10.1016/j.urolonc.2019.12.027

M3 - SCORING: Journal article

C2 - 32001198

VL - 38

SP - 379

EP - 385

JO - UROL ONCOL-SEMIN ORI

JF - UROL ONCOL-SEMIN ORI

SN - 1078-1439

IS - 5

ER -