A known fact is that between 15% to 35% of men who have surgery as their primary treatment after diagnosis of prostate cancer will experience a biochemical recurrence (BCR).
The authors of a presentation, Michael B. Williams, MD, et al. presented at the American Urological Association Mid-Atlantic Section – 67th Annual Meeting – October 1 – 4, 2009 – Williamsburg Lodge – Williamsburg, VA, evaluated PSA doubling time (PSADT) and time to PSA recurrence as predictors for the development of metastatic disease.
The men in the study all underwent a radical prostatectomy from 1989 to 2003 from a single institution. The primary endpoints that they evaluated were death and progression to metastatic disease.
Two hundred and six (206) men, over a mean follow up period of 7.8 years, were evaluated in this study. Prostate cancer mortality over the follow up period was 2.4%. Forty nine percent (49%) of the men had androgen deprivation therapy (ADT) and 32% underwent salvage radiotherapy prior to the development of metastatic disease.
They found that the 10-year freedom from metastases was significantly worse in patients with a BCR of <12 months following surgery (78% vs. 90.8%). A PSADT of <10 months was associated with a 3.8 fold increase risk of metastatic disease.The authors concluded that BCR within the first year of prostatectomy and a PSADT of <10 months are risk factors for progression to metastatic disease.Joel T Nowak MA, MSW