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Renal & Urology NewsPredictors of PSA Persistence After RP for Node-Positive Prostate Cancer ID’d

New Study Reveals Factors Significantly Impacting PSA Levels Post-Operative in Men with Positive Lymph Nodes

In a recent study published in European Urology Oncology, researchers have identified key factors that predict PSA persistence in men who have undergone radical prostatectomy and extended lymph node dissection. The study sheds light on the likelihood of PSA persistence based on preoperative and biopsy findings, offering healthcare professionals a new tool for risk stratification.

HCN Medical Memo
This study provides a valuable framework for assessing the risk of PSA persistence in men undergoing prostate cancer surgery. Understanding these predictors can guide treatment plans and inform patient discussions, particularly when considering a multimodal approach to care. The identification of risk factors such as SVI staging and high ISUP grade can help clinicians make more informed decisions, potentially leading to better oncological outcomes.

Key Points
  • Among 519 men who underwent radical prostatectomy, 88 (17%) showed nodal uptake on preoperative PSMA PET scans.
  • PSA persistence, defined as a PSA value of 0.1 ng/mL or greater at the first post-operative measurement, occurred in 36% of these 88 men.
  • Multivariable analyses revealed that having more than two positive lymph nodes, seminal vesicle invasion (SVI) staging, or a high ISUP grade significantly predicted PSA persistence.
  • Men with these characteristics had 2.1- to 5.1-fold increased odds of experiencing PSA persistence.

According to the American Cancer Society, about 1 in 8 men will be diagnosed with prostate cancer during his lifetime, making it the second most common cancer among men in the United States.

Additional Points
  • The study created a risk stratification model with good discrimination (area under the curve 78%).
  • External validation of the risk stratification model is still pending.

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