PSA Recurrence Overdetected After Prostatectomy
For some men, prostate cancer recurrence may be overdetected, especially in those over 70.
Prostate-specific antigen recurrence (PSA-R) may be overdetected after radical prostatectomy (RP), according to research published in Clinical Cancer Research.
Jing Xia, Ph.D., from the Fred Hutchinson Cancer Research Center in Seattle, and colleagues estimated the times from PSA-R to metastasis for 441 patients with RP who did not receive salvage treatment at PSA-R. Using U.S. life tables to reflect other-cause survival among RP cases in the Surveillance, Epidemiology, and End Results (SEER) registry, the authors examined the times to other-cause death.
The chance that other-cause death would precede clinical metastasis was estimated for 4,455 patients with disease characteristics based on the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE) database.
The researchers found that at five and 10 years, the cumulative incidence of PSA-R was 13.6 and 19.9 percent, respectively, in CaPSURE. In patients with RP in SEER, the risk of other-cause death was 60 percent lower than the age-matched U.S. population.
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Overdetection occurred in at least 9.1 and 15.6 percent of patients with PSA-R less than five years and five to 10 years after RP, respectively. Among patients aged over 70 years at diagnosis who recurred within 10 years of diagnosis, at least 34.1 percent were overdetected.
"The potential for overdetection of recurrence confirms the need for approaches to determine whether and when to initiate salvage therapies," the authors write.
One author disclosed financial ties to Myriad Genetics and providing expert testimony for a medical company.