NDLI: Study of prostate-specific antigen levels during salvage radiotherapy after prostate cancer surgery

Content Provider	Springer Nature : BioMed Central
Author	Aizawa, Takuya Maebayashi, Toshiya Ishibashi, Naoya Sakaguchi, Masakuni Sato, Akahiko Yamaguchi, Kenya
Abstract	Background Administration of adjuvant or salvage radiotherapy (RT) after prostate cancer (PCa) surgery is supported by clinical evidence and is a widely adopted strategy. On occasion, we detect changes in prostate-specific antigen (PSA) levels, such as a transient elevation or decline, during RT. Thus, we retrospectively investigated the frequency of changes in PSA levels, their associations with histopathological parameters, PSA doubling time (PSADT), and biochemical recurrence (BR) of PCa. Methods This study included 23 consecutive patients who underwent surgery for PCa between 2012 and 2019, received salvage RT without hormone therapy, and exhibited changes in PSA levels during RT. The prostatic bed was irradiated with a total dose of 64 to 66 Gy. BR was defined as consecutive PSA levels exceeding 0.2 ng/mL or having to start hormone therapy because of PSA elevation after salvage RT. Results During salvage RT after PCa surgery, PSA levels transiently increased in 11 patients (47.8%) and decreased in 12 (52.2%). When factors associated with BR were examined in patients with transient PSA elevation, seminal vesicle invasion and preoperative PSA values were identified as being statistically significant. When factors for BR were examined in patients with a decline in PSA levels, the Gleason score and PSADT were identified as being significant. Among the cases of a decline in PSA levels during salvage RT, those who received a radiation dose of less than 36 Gy did not experience BR. Similarly, patients who exhibited changes in PSA levels during salvage RT and did not have perineural invasion did not experience BR. Conclusion This is the first study to examine the histopathological factors possibly affecting BR in patients undergoing salvage RT after PCa surgery. The results indicate that in patients with transient PSA elevation, seminal vesicle invasion is a significant risk factor. On the other hand, in patients with a decline in PSA levels during irradiation, the Gleason score and perineural invasion were found to be potential risk factors for BR. These findings suggest that a thorough examination of postoperative histopathological results may be necessary for the optimal management of patients with PCa.
Related Links	https://bmcurol.biomedcentral.com/counter/pdf/10.1186/s12894-023-01323-5.pdf
Ending Page	8
Page Count	8
Starting Page	1
File Format	HTM / HTML
ISSN	14712490
DOI	10.1186/s12894-023-01323-5
Journal	BMC Urology
Issue Number	1
Volume Number	23
Language	English
Publisher	BioMed Central
Publisher Date	2023-10-04
Access Restriction	Open
Subject Keyword	Urology Internal Medicine PSA PSADT Prostate cancer Radiotherapy Biochemical recurrence
Content Type	Text
Resource Type	Article
Subject	Urology Reproductive Medicine
Journal Impact Factor	1.7/2023
5-Year Journal Impact Factor	2/2023

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