External validation of the "optimal PSA follow-up schedule after radical prostatectomy” in a new cohort

Background Biochemical recurrence (BCR) after radical prostatectomy (RP) is most commonly diagnosed by detecting an increase in asymptomatic prostate-specific antigen (PSA). We previously reported the “optimal PSA follow-up schedule after RP”. The aim of this study was to confirm the usefulness and...

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Bibliographic Details
Published in:International journal of clinical oncology 2020-07, Vol.25 (7), p.1393-1397
Main Authors: Yanai, Yoshinori, Matsumoto, Kazuhiro, Kosaka, Takeo, Takeda, Toshikazu, Tanaka, Nobuyuki, Morita, Shinya, Mizuno, Ryuichi, Shinojima, Toshiaki, Asanuma, Hiroshi, Oya, Mototsugu
Format: Article
Language:English
Subjects:
Cancer Research
Cancer surgery
Medicine
Medicine & Public Health
Oncology
Original Article
Prostate
Prostate cancer
Prostate-specific antigen
Prostatectomy
Surgical Oncology
Urological surgery
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Summary:Background Biochemical recurrence (BCR) after radical prostatectomy (RP) is most commonly diagnosed by detecting an increase in asymptomatic prostate-specific antigen (PSA). We previously reported the “optimal PSA follow-up schedule after RP”. The aim of this study was to confirm the usefulness and safety of that follow-up schedule in another cohort. Methods We retrospectively reviewed the clinicopathological data of 798 consecutive patients who underwent radical prostatectomy between 2009 and 2017. We examined all PSA values measured during follow-up. Furthermore, we estimated the PSA value when we observed the “optimal PSA follow-up schedule” at each timing in the virtual follow-up. BCR was defined as an elevation of PSA to greater than 0.2 ng/ml, and the ideal PSA range for detection of BCR was regarded to be 0.2–0.4 ng/ml. Results During the mean follow-up period of 5.8 years, BCR occurred in 115 (14.9%) patients and the frequency of virtual follow-up was significantly lower than the actual frequency. However, overlooking of BCR (detecting BCR when PSA exceeded 0.4 ng/ml) was observed in 17 patients, which is higher than the actual frequency of overlooking (12 patients). Therefore, we modified the follow-up schedule, which could achieve the lower follow-up frequency and a limited number of overlooking of BCR (7 patients). Conclusion This external validation study revealed that the "modified optimal PSA follow-up schedule after RP" can reduce the frequency of PSA measurement with a limited risk of overlooking BCR.
ISSN:1341-9625
1437-7772
DOI:10.1007/s10147-020-01676-z