AU - Hachiya T; Endo M; Nogaki J; Ishida H; Okada K
TI - Significance of prostate-specific antigen after radical prostatectomy.
SO - Int J Urol 1997;4(5):461-6
AD - Department of Urology, Nihon University, School of Medicine, Tokyo,
Japan.

AB - BACKGROUND: Serum prostate-specific antigen (PSA) is expected to be
undetectable after radical prostatectomy unless there is residual
disease or disease progression. The aim of this study was to confirm
the usefulness of serum PSA measurements in monitoring patients after
radical prostatectomy. METHODS: We conducted a study of 50 patients
who underwent radical prostatectomy for clinical stage T1-2 or small
T3 prostate cancer, analyzed serum PSA levels before and after
surgery and compared the pathological findings and clinical outcome.
RESULTS: Postoperative PSA elevation (PSA failure) was noted in 13%
of patients with organ-confined disease (OCD), 43% with positive
surgical margins and/or seminal vesicle involvement (PSM/SVI), and
60% with positive lymph nodes (N+). Postoperative clinical failure
was noted in 8 patients, and all were preceded by PSA failures. The
3-year PSA failure-free rates were 86.5%, 32.1%, and 40.7% and the
3-year clinical failure-free rates were 100%, 67.5%, and 73.5% in
patients with OCD, PSM/SVI and N+, respectively. CONCLUSION: An
elevation of serum PSA levels after radical prostatectomy was a
sensitive indicator of persistent disease after surgery, and preceded
clinical manifestations of disease progression.