Login to Access Video or Poster Abstract: MP64-19
Sources of Funding: None

Introduction

Persistently elevated prostate-specific antigen (PSA) after radical prostatectomy (RP) is associated with recurrent disease and poor prognosis. Predictors that may be associated with persistent PSA need to be evaluated in order to better counsel patients and gauge postoperative outcomes. We sought to assess independent clinical and pathologic predictors of persistently elevated PSA after RP in a contemporary cohort.

Methods

We identified a cohort of patients with non-metastatic prostate cancer who underwent RP from 2006-2016 at the Cleveland Clinic Foundation. Independent predictors of persistently elevated PSA were identified using chi-square and multivariate logistic regression analyses, accounting for patient demographic and clinicopathologic factors. Persistently elevated PSA was defined as ≥0.1 six weeks after RP.

Results

Of a total 2,710 patients undergoing RP, 158 patients had persistently elevated PSA after surgery (5.8%). On multivariate analysis, clinicopathologic factors associated with persistently elevated PSA included initial PSA >20 ng/mL (OR 2.8; p<0.01), extra-prostatic extension (OR 3.3; p<0.01), seminal vesicle invasion (OR 1.6; p=0.048), positive surgical margin (OR 2.0; p<0.01), lymph node involvement (OR 2.5; p<0.01), and pathologic Gleason score ≥8 (OR 4.5; p<0.01).

Conclusions

With persistently elevated PSA after RP recognized as a marker of continued disease progression, clinicopathologic factors that predicted persistently elevated PSA were characterized in a contemporary cohort. These results highlight factors that can assist with determination of necessity for adjuvant therapy and help with better patient counseling prior to and following prostatectomy.

Funding

None