After a median follow-up period of 52.2 months, the biochemical "failure-free" rate in the PSA nadir <0.008 and ≥0.008 ng/ml groups was 94.3 and 58.8%, respectively,
Thompson et al (11) reported that adjuvant radiotherapy following RP for stage pT3N0M0 prostate cancer significantly reduces the risk of metastasis and increases survival
however, the improvements in clinical progression-free survival were not maintained.
Late adverse effects (any type of any grade) were more frequent in the postoperative irradiation compared to the wait-and-see group.
In addition to potential problems with the reagents and measurement methods, there exists the possibility of ‘noise’ created by residual benign prostate tissue during measurement, or the production of PSA by the periurethral glands or other organs.
There are three trends in ultra-sensitive PSA;
a) the temporary elevation type group, PSA levels increased temporarily, followed by a subsequent decrease to <0.008 ng/ml
b) the consecutive elevation type group (PSA≥0.05 ng/ml) and
c) the peaking out type group (0.008≤PSA<0.05 ng/ml)
The consecutive elevation type group, transited to <0.05 ng/ml
Cases with the pathological factors ≥pT3 and EPE are mainly following the transition of the consecutive elevation type group.
The European Association of Urology guidelines state that patients with a PSA level of 0.1–0.2 ng/ml following RP do not exhibit either clinical or biochemical disease progression.
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