Risk of Prostate Cancer–Specific Mortality Following Biochemical Recurrence After Radical Prostatectomy

Stephen J. Freedland,  JAMA. 2005;294:433-439.

Retrospective cohort study of 379 men who had undergone radical prostatectomy at an urban tertiary care hospital between 1982 and 2000 and who had a biochemical recurrence and after biochemical failure had at least 2 prostate-specific antigen (PSA) values at least 3 months apart in order to calculate PSA doubling time (PSADT). The mean (SD) follow-up after surgery was 10.3 (4.7) years and median follow-up was 10 years (range, 1-20 years).

Main Outcome Measure  Prostate cancer–specific mortality.

Results  Median survival had not been reached after 16 years of follow-up after biochemical recurrence. Prostate-specific doubling time (<3.0 vs 3.0-8.9 vs 9.0-14.9 vs ≥15.0 months), pathological Gleason score (≤7 vs 8-10), and time from surgery to biochemical recurrence (≤3 vs >3 years) were all significant risk factors for time to prostate-specific mortality. Using these 3 variables, tables were constructed to estimate the risk of prostate cancer–specific survival at year 15 after biochemical recurrence.