Do patients with low volume prostate cancer have prostate specific antigen recurrence following radical prostatectomy?
- B Furusato1,3,
- I L Rosner2,
- D Osborn2,
- A Ali3,
- S Srivastava3,
- C J Davis1,
- I A Sesterhenn1,
- D G McLeod2,3
- 1Department of Genitourinary Pathology, Armed Forces Institute of Pathology, Washington, DC, USA
- 2Department of Surgery, Urology Service, Walter Reed Army Medical Center, Washington, DC, USA
- 3Center for Prostate Disease Research, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
- David G McLeod, Center for Prostate Disease Research and Director, Urologic Oncology, 6900 Georgia Ave, NW Washington, DC 20307, USA;
- Accepted 15 May 2008
- Published Online First 13 June 2008
Aims: The objective of this study was to determine the incidence of prostate specific antigen (PSA) relapse in patients with low volume prostate cancer following radical prostatectomy.
Methods: Between 1993 and 2001, 50 of 717 patients had total tumour volumes of less than 0.5 cm3 following radical prostatectomy. Biochemical recurrence was defined as two consecutive values of serum PSA levels of 0.2 ng/ml or greater.
Results: Median follow-up of the 50 patients was 58 months. In five of the 50 patients (10%), PSA recurrence was observed. All of these five cases had Gleason score of 3+3 (well and/or moderately differentiated), organ confined and surgical margin negative tumours. In three of the five cases, capsular incision resulted in benign glands extending into the surgical margin.
Conclusions: Five of 50 cases had PSA failure. In three of the five patients, benign glands located in the margin could explain the “PSA recurrence”. However, in the other two patients, none of the pathological parameters correlated with measurable PSA levels. The explanation for their PSA failure is unclear.
Funding: This research was supported by the Center for Prostate Disease Research Program through the Henry M Jackson Foundation for the Advancement of Military Medicine under contract number HU001-04-C-1502 and by NIH Grant RO1 DK065977 (DM and SS).
Competing interests: The views expressed in this article are those of the authors and do not reflect the official policy of the Department of the Army, Department of Defense, or the U.S. Government. The authors have indicated no potential conflicts of interest.
Ethics approval: Ethics approval was obtained from the ethics committee of the Walter Reed Army Medical Centre.
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