Study of prostate-specific antigen levels during salvage radiotherapy after prostate cancer surgery
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, duri...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | BMC Urology |
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| Online Access: | https://doi.org/10.1186/s12894-023-01323-5 |
| _version_ | 1797451359029559296 |
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| author | Takuya Aizawa Toshiya Maebayashi Naoya Ishibashi Masakuni Sakaguchi Akahiko Sato Kenya Yamaguchi |
| author_facet | Takuya Aizawa Toshiya Maebayashi Naoya Ishibashi Masakuni Sakaguchi Akahiko Sato Kenya Yamaguchi |
| author_sort | Takuya Aizawa |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-09T14:53:32Z |
| format | Article |
| id | doaj.art-bbd380ef536141938cfe565d91a72b71 |
| institution | Directory Open Access Journal |
| issn | 1471-2490 |
| language | English |
| last_indexed | 2024-03-09T14:53:32Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Urology |
| spelling | doaj.art-bbd380ef536141938cfe565d91a72b712023-11-26T14:20:51ZengBMCBMC Urology1471-24902023-10-012311810.1186/s12894-023-01323-5Study of prostate-specific antigen levels during salvage radiotherapy after prostate cancer surgeryTakuya Aizawa0Toshiya Maebayashi1Naoya Ishibashi2Masakuni Sakaguchi3Akahiko Sato4Kenya Yamaguchi5Department of Radiology, Nihon University School of MedicineDepartment of Radiology, Nihon University School of MedicineDepartment of Radiology, Nihon University HospitalDepartment of Radiology, Nihon University School of MedicineDepartment of Radiology, Nihon University School of MedicineDepartment of Urology, Nihon University HospitalAbstract 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.https://doi.org/10.1186/s12894-023-01323-5PSAPSADTProstate cancerRadiotherapyBiochemical recurrence |
| spellingShingle | Takuya Aizawa Toshiya Maebayashi Naoya Ishibashi Masakuni Sakaguchi Akahiko Sato Kenya Yamaguchi Study of prostate-specific antigen levels during salvage radiotherapy after prostate cancer surgery BMC Urology PSA PSADT Prostate cancer Radiotherapy Biochemical recurrence |
| title | Study of prostate-specific antigen levels during salvage radiotherapy after prostate cancer surgery |
| title_full | Study of prostate-specific antigen levels during salvage radiotherapy after prostate cancer surgery |
| title_fullStr | Study of prostate-specific antigen levels during salvage radiotherapy after prostate cancer surgery |
| title_full_unstemmed | Study of prostate-specific antigen levels during salvage radiotherapy after prostate cancer surgery |
| title_short | Study of prostate-specific antigen levels during salvage radiotherapy after prostate cancer surgery |
| title_sort | study of prostate specific antigen levels during salvage radiotherapy after prostate cancer surgery |
| topic | PSA PSADT Prostate cancer Radiotherapy Biochemical recurrence |
| url | https://doi.org/10.1186/s12894-023-01323-5 |
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