Does PSADT After Radical Prostatectomy Predict Overall Survival?—A Report from the SEARCH Database Group

March 2009 in “ The Journal of Urology ”

Anna E. Teeter, Jospeh C. Presti, William J. Aronson, Martha K. Terris, Christopher J. Kane, Christopher L. Amling, Stephen J. Freedland

prostate-specific antigen PSADT radical prostatectomy overall survival prognostic tool mortality risk PSA RP OS

TLDR Shorter PSADT after prostate surgery is linked to higher risk of death.

The study from the SEARCH database group investigated whether prostate-specific antigen doubling time (PSADT) after radical prostatectomy (RP) could predict overall survival (OS) in a cohort of 360 men who underwent RP between 1988 and 2008. The men were part of an older, racially diverse population treated at multiple Veterans Affairs medical centers. The results showed that a PSADT of less than 3 months (HR 9.63, p<0.001) and a PSADT of 3-8.9 months (HR 2.33, p=0.002) were associated with poorer OS compared to men with a PSADT of 9 months or more. For men with a PSADT greater than 9 months, PSADT was not significantly correlated with OS. The conclusion was that a PSADT of less than 9 months significantly increased the risk of mortality, making PSADT a useful prognostic tool for identifying men at increased risk of mortality early in the course of their disease. This study validated previous findings from tertiary care referral centers on the importance of PSADT as a prognostic indicator.

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