Evidence to support a continued stage migration and decrease in prostate cancer specific mortality

Shira L. Galper*, Ming Hui Chen, William J. Catalona, Kimberly A. Roehl, Jerome P. Richie, Anthony V. D'Amico

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

73 Scopus citations

Abstract

Purpose: We evaluated whether the proportion of patients with a postoperative PSA-DT less than 3 months, a surrogate for PCSM, decreased significantly during the PSA era. Materials and Methods: Between July 1988 and July 2002, 3,719 men with clinically localized prostate cancer treated with RP comprised the study cohort. A chi-square metric was used to compare the preoperative and postoperative characteristics, 5-year actual PSA failure rates, and PSA-DTs for patients treated during the 2 equally divided eras of the early PSA era, July 1988 to July 1995 and the late PSA era, August 1995 to July 2002. Results: Patients presenting in the more recent PSA era were of younger age (p <0.0001), with earlier stage (p <0.0001) and lower grade disease (p = 0.01). Similarly, patients had lower grade (p <0.001), stage (p <0.0001), and positive margin (p <0.0001) and lymph node rates (p = 0.0002) at RP. The 5-year actual PSA failure rates decreased from 14.3% in the early PSA era to 2.5% in the later PSA era (p <0.0001). There was a 37% reduction in the proportion of patients with a PSA-DT less than 3 months, corresponding to a decrease in absolute magnitude from 9% to 5.7% between the 2 eras. Absolute reductions of 3.1% and 9% were also noted for the proportion of PSA-DTs of 3 to 5.99 months and 6 to 11.99 months, respectively, whereas PSA-DTs of 12 months or greater increased by 15.3%. Conclusions: During the recent PSA era, postoperative PSA failure has significantly decreased and PSA-DTs have increased, suggesting that PCSM will continue to decrease.

Original languageEnglish (US)
Pages (from-to)907-912
Number of pages6
JournalJournal of Urology
Volume175
Issue number3
DOIs
StatePublished - Mar 2006

Keywords

  • Mass screening
  • Prostate-specific antigen
  • Prostatectomy
  • Prostatic neoplasms
  • Treatment failure

ASJC Scopus subject areas

  • Urology

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