Login to Access Video or Poster Abstract: MP64-04
Sources of Funding: None

Introduction

Biochemical failure after radical prostatectomy (RP) is defined by two consecutive serum prostate specific antigen (PSA)values of >0.2ng/mL. This value has been determined based on retrospective studies in men who had undergone RP for localized prostate cancer. However retrospective design and probability of extra-prostatic extension affect the accuracy of the aforesaid cut-off value. To determine a more accurate PSA nadir value we measured serum PSA after cystoprostatectomy in patients with bladder urothelial cancer and no evidence of prostatic malignancy.

Methods

Fifty two consecutive patients underwent radical cystoprostatectomy for muscle invasive bladder cancer in our institution between December 2010 and December 2013. Histopathological evaluation of prostatic tissue was performed in slices with 3 micrometers in thickness. Any evidence of prostatic adenocarcinoma and/or high grade prostatic intraepithelial neoplasia were considered as exclusion criteria. Additional exclusion criteria were prostatic involvement with urothelial carcinoma, neoadjuvant or adjuvant chemotherapy and radiation therapy. Among all patients, 41 were eligible for study. Serum PSA level was measured using immunochemiluminescence technique between 6 month and 3 years after surgery in study participants.

Results

Forty one patients with mean age of 66.4±8.9 were evaluated in this study. Mean serum PSA level after radical cystoprostatectomy was 0.037±0.031 ng/mL (ranging from 0.002 to 0.1). Serum PSA level was not affected by either surgical technique or interval between surgery and PSA measurement. Mean serum PSA level in our study was significantly lower than 0.2 ng/mL which is considered as PSA nadir value after RP.

Conclusions

Serum PSA level of 0.2 ng/mL which is considered as PSA nadir level may be inaccurate and delay salvage treatment. Our results showed that cut off value of ≤0.1 ng/mL may be more accurate.

Funding

None