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Does early prostate-specific antigen doubling time (ePSADT) after radical prostatectomy, calculated using PSA values from the first detectable until the first recurrence value, correlate with standard PSADT? A report from the Shared Equal Access Regional Cancer Hospital Database Group

  1. Anna E. Teeter1,2,
  2. Joseph C. Presti Jr4,5,
  3. William J. Aronson6,7,
  4. Martha K. Terris8,9,
  5. Christopher J. Kane10,
  6. Christopher L. Amling11,
  7. Stephen J. Freedland1,2,3,*

Article first published online: 22 JUN 2009

DOI: 10.1111/j.1464-410X.2009.08680.x

Issue

BJU International

BJU International

Volume 104, Issue 11, pages 1604–1609, December 2009

Additional Information

How to Cite

Teeter, A. E., Presti Jr, J. C., Aronson, W. J., Terris, M. K., Kane, C. J., Amling, C. L. and Freedland, S. J. (2009), Does early prostate-specific antigen doubling time (ePSADT) after radical prostatectomy, calculated using PSA values from the first detectable until the first recurrence value, correlate with standard PSADT? A report from the Shared Equal Access Regional Cancer Hospital Database Group. BJU International, 104: 1604–1609. doi: 10.1111/j.1464-410X.2009.08680.x

Author Information

  1. 1

    Division of Urologic Surgery and the Duke Prostate Center, Department of Surgery, Duke University Medical Center,

  2. 2

    Urology Section, Department of Surgery, Veterans Affairs (VA) Medical Center,

  3. 3

    Department of Pathology, Duke University School of Medicine, Durham, NC,

  4. 4

    Department of Urology, Stanford University Medical Center,

  5. 5

    Urology Section, Department of Surgery, VA Medical Center, Palo Alto, CA,

  6. 6

    Urology Section, Department of Surgery, VA Medical Center,

  7. 7

    Department of Urology, University of California at Los Angeles Medical Center, Los Angeles, CA,

  8. 8

    Urology Section, Division of Surgery, VA Medical Center,

  9. 9

    Section of Urology, Department of Surgery, The Medical College of Georgia, Augusta, GA,

  10. 10

    Division of Urology, Department of Surgery, University of California at San Diego Medical Center, San Diego, CA, and

  11. 11

    Division of Urology, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA

*Stephen J. Freedland, Division of Urologic Surgery and the Duke Prostate Center, and Departments of Surgery and Pathology, Box 2626, Duke University Medical Center, Durham, NC 27710, USA. e-mail: steve.freedland@duke.edu

Publication History

  1. Issue published online: 10 NOV 2009
  2. Article first published online: 22 JUN 2009
  3. Accepted for publication 30 March 2009

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Keywords:

  • prostate cancer;
  • PSADT;
  • biochemical recurrence;
  • tumour markers

OBJECTIVE

To determine if prostate-specific antigen doubling time (PSADT), calculated from the first detectable PSA level after radical prostatectomy (RP) to the first PSA level of ≥0.2 ng/mL (early PSADT or ePSADT), correlated with ‘standard’ PSADT (henceforth PSADT) calculated using values ≥0.2 ng/mL, as a short PSADT following biochemical recurrence (BCR) after RP portends a poor prognosis and poor response to salvage treatment but this is based upon PSADT calculated using PSA values of ≥0.2 ng/mL.

PATIENTS AND METHODS

We used Spearman’s correlation to determine the correlation between ePSADT and PSADT among 157 men in the Shared Equal Access Regional Cancer Hospital database who underwent RP between 1988 and 2005 and had a calculable ePSADT and PSADT. We systematically examined ePSADT thresholds and their positive and negative predictive values (PPV and NPV, respectively), to predict aggressive recurrences (PSADT of <9 months).

RESULTS

ePSADT was significantly, though poorly, correlated with PSADT (r = 0.30, P < 0.001). ePSADT more accurately predicted PSADT among men with a long ePSADT. Of men with an ePSADT of ≥20 or ≥15 months, the NPV for an aggressive recurrence was 98% and 93%, respectively. However, among men with an ePSADT of <3 months, the PPV for aggressive recurrence was only 39%.

CONCLUSIONS

Although ePSADT and PSADT were significantly related, the overall correlation was poor. This was highlighted by the finding that only 39% of men with the shortest ePSADT (<3 months) had a PSADT of <9 months. However, a long ePSADT correlated well with a long PSADT and is thus useful in identifying men at low risk for prostate cancer-specific mortality very early in their BCR.

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