- Initial very high PSA levels are associated with a higher risk for biochemical recurrence (BCR), metastatic progression, and cancer-specific mortality (CSM) in patients with localized prostate cancer undergoing radical prostatectomy.
Why this matters
- Very high risk patients with potentially undetected metastases may benefit from multimodal treatment strategies including local treatment.
- 2811 patients with clinically localized prostate cancer and initial PSA ≥20 ng/mL underwent radical prostatectomy.
- Funding: No external funding.
- 16.2% and 5.8% of patients had a PSA of 50-99.9 and ≥100 ng/mL, respectively.
- Median follow-up, 47.5 months.
- At 10 years, patients with PSA 20-49.9, 50-99.9, and ≥100 ng/mL showed a significant difference in:
- BCR-free survival rates: 46.9%, 32.1%, and 29.0%, respectively (P<.001>
- Metastasis-free survival rates: 78.4%, 67.2%, and 37.3%, respectively (P<.001>
- CSS rates: 93.7%, 85.5%, and 66.7%, respectively (P<.001>
- BCR: HR, 1.3 (P<.001 and respectively.>
- Metastatic progression: HR, 1.4 (P=.04) and 2.3 (P<.001 respectively.>
- CSM: HR, 1.9 (P<.01 and respectively.>
- Retrospective design.