Mp67-18 impact of persistent psa in salvage radical prostatectomy patients - a multicenter study

You have accessJournal of UrologyCME1 Apr 2023MP67-18 IMPACT OF PERSISTENT PSA IN SALVAGE RADICAL PROSTATECTOMY PATIENTS - A MULTICENTER STUDY Reha-Baris Incesu, Felix Preisser, Pawel Rajwa, Marcin Chlosta, Mohamed Ahmed, Andre Abreu, Giovanni Cacciamani, Luis Ribeiro, Alexander Kretschmer, Thilo Westhofen, Joseph A Smith, Giorgio Calleris, Yannic Raskin, Paolo Gontero, Steven Joniau, Rafael Sanchez-Salas, Henk Van Der Poel, Paul Cathcart, Inderbir Gill, R Jeffrey Karnes, Shahrokh F Shariat, Thomas Steuber, Giancarlo Marra, and Derya Tilki Reha-Baris IncesuReha-Baris Incesu More articles by this author , Felix PreisserFelix Preisser More articles by this author , Pawel RajwaPawel Rajwa More articles by this author , Marcin ChlostaMarcin Chlosta More articles by this author , Mohamed AhmedMohamed Ahmed More articles by this author , Andre AbreuAndre Abreu More articles by this author , Giovanni CacciamaniGiovanni Cacciamani More articles by this author , Luis RibeiroLuis Ribeiro More articles by this author , Alexander KretschmerAlexander Kretschmer More articles by this author , Thilo WesthofenThilo Westhofen More articles by this author , Joseph A SmithJoseph A Smith More articles by this author , Giorgio CallerisGiorgio Calleris More articles by this author , Yannic RaskinYannic Raskin More articles by this author , Paolo GonteroPaolo Gontero More articles by this author , Steven JoniauSteven Joniau More articles by this author , Rafael Sanchez-SalasRafael Sanchez-Salas More articles by this author , Henk Van Der PoelHenk Van Der Poel More articles by this author , Paul CathcartPaul Cathcart More articles by this author , Inderbir GillInderbir Gill More articles by this author , R Jeffrey KarnesR Jeffrey Karnes More articles by this author , Shahrokh F ShariatShahrokh F Shariat More articles by this author , Thomas SteuberThomas Steuber More articles by this author , Giancarlo MarraGiancarlo Marra More articles by this author , and Derya TilkiDerya Tilki More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003330.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Persistent prostatic specific antigen (PSA) represents a poor prognostic factor for recurrence after radical prostatectomy (RP). However, the impact of persistent PSA on oncologic outcomes in salvage RP patients is unknown. To investigate the impact of persistent PSA after salvage RP on long-term oncologic outcomes. METHODS: Patients who underwent salvage RP for recurrent prostate cancer between 2000 and 2021were identified from 11 high-volume centers. Only patients with available PSA after salvage RP were included. Kaplan-Meier analyses and multivariable Cox regression models were used to test the effect of persistent PSA, defined as PSA ≥0.1ng/ml postoperative on biochemical recurrence (BCR) and death after salvage RP. RESULTS: Overall, 580 patients were identified. Of those, 41.7% (n=242) harbored persistent PSA. Median follow-up was 38 months, median time to salvage RP was 64 months and median time to first PSA after salvage RP was 2.2 months. Patients with persistent PSA had higher median preoperative PSA values (5.8 vs. 4.4 ng/ml, p<0.01), higher proportion of positive margins (40.1 vs. 24.0%, p<0.001), more frequently harbored seminal vesicle invasion (45.9 vs. 24.0%, p<0.001) and lymph node invasion (27.3 vs. 5.9%, p<0.001). At 120 months after salvage RP, BCR-free and overall survival was 6.6 vs. 51.7% and 70.8 vs. 88.2% for patients with persistent vs. undetectable PSA after salvage RP (all p<0.01). In multivariable Cox models persistent PSA was an independent predictor for BCR (HR: 5.6, p<0.001) and death (HR: 3.0, p<0.01). In multivariable logistic regression models higher preoperative PSA (OR: 1.04, p=0.03) and biopsy Gleason 8-10 (OR: 2.24, p<0.01) were independent predictors for PSA persistence after salvage RP. CONCLUSIONS: Persistent PSA is common after salvage RP and represents an independent predictor for worse oncologic outcome after salvage RP. Salvage RP patients should be closely monitored after surgery to identify those with persistent PSA. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e950 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Reha-Baris Incesu More articles by this author Felix Preisser More articles by this author Pawel Rajwa More articles by this author Marcin Chlosta More articles by this author Mohamed Ahmed More articles by this author Andre Abreu More articles by this author Giovanni Cacciamani More articles by this author Luis Ribeiro More articles by this author Alexander Kretschmer More articles by this author Thilo Westhofen More articles by this author Joseph A Smith More articles by this author Giorgio Calleris More articles by this author Yannic Raskin More articles by this author Paolo Gontero More articles by this author Steven Joniau More articles by this author Rafael Sanchez-Salas More articles by this author Henk Van Der Poel More articles by this author Paul Cathcart More articles by this author Inderbir Gill More articles by this author R Jeffrey Karnes More articles by this author Shahrokh F Shariat More articles by this author Thomas Steuber More articles by this author Giancarlo Marra More articles by this author Derya Tilki More articles by this author Expand All Advertisement PDF downloadLoading ...