Analysis of factors affecting first serum prostate specific antigen level after radical prostatectomy for prostate cancer

Abstract

Objective To analyze the factors affecting postoperative first serum prostate specific antigen (PSA) level at 6 weeks in patients receiving radical prostatectomy (RP) for prostate cancer. Methods The clinicopathological data were collected retrospectively from 251 patients undergoing RP for prostate cancer in our department between January, 2014 and May, 2018. According to postoperative first serum PSA levels at 6-8 weeks for assessing biochemical recurrence (with 0.2 ng/mL as the cut-off PSA level), the patients were divided into PSA < 0.2 ng/mL group and PSA≥0.2 ng/mL group, and univariate analysis and multivariate Logistic regression analysis was performed to identify the factors affecting first serum PSA level after RP. Results The two groups of patients with prostate cancer showed significant differences in BMI, history of preoperative electric resection, preoperative PSA level, postoperative Gleason score, pathological T staging, lymph node dissection, and the number of dissected lymph nodes (P < 0.05). The results of multivariate Logistic regression analysis showed that BMI, preoperative PSA level, postoperative Gleason score and pathological T staging were all independent risk factors affecting postoperative first serum PSA level. In the 153 patients with lymph node dissection, BMI, preoperative PSA level, postoperative Gleason score, pathological T staging, lymph node positivity and the number of positive lymph nodes differed significantly between the patients with postoperative PSA level < 0.2 ng/mL at 6 weeks and those with higher PSA levels (P < 0.05). Multivariate Logistic regression analysis showed that preoperative PSA level and lymph node positivity were independent risk factors that affected the postoperative first serum PSA level. Conclusion BMI, preoperative PSA level, postoperative Gleason score and pathologic T staging are all independent risk factors affecting the postoperative first serum PSA level in prostate cancer patients; In patients with lymph node dissection, preoperative PSA level and lymph node positivity are independent risk factors affecting the postoperative first serum PSA level.

Keywords

• radical prostatectomy
• prostate cancer
• biochemical recurrence
• logistic regression analysis