Significance of normal serum prostate-specific antigen in the follow-up period after definitive radiation therapy for prostatic cancer Journal Article


Authors: Zelefsky, M. J.; Leibel, S. A.; Wallner, K. E.; Whitmore, W. F. Jr; Fuks, Z.
Article Title: Significance of normal serum prostate-specific antigen in the follow-up period after definitive radiation therapy for prostatic cancer
Abstract: Purpose: To determine the prognostic significance of a normal serum prostate-specific antigen (PSA) level in patients with prostatic cancer with long-term follow-up evaluation after radiotherapy. Materials and Methods: PSA information was available in 403 patients (38%) who were treated with pelvic lymph node dissection and retropubic radioactive iodine-125 implantation. One hundred eighty-two patients had a normal serum PSA level (≤ 4.0 ng/mL) the first time this test was conducted during the follow-up period, designated PSA-1. Results: Among patients with PSA-1 values ≤ 1.0 ng/ mL, the 5-year PSA relapse-free survival rate was 85% compared with 27%, respectively, among those with PSA values in the higher range of normal (P < .00001). Multi- variate analysis demonstrated that only a PSA-1 value greater than 1.0 to ≤ 4.0 (P < .00001) and grade II/III histology (P = .009) had a negative impact on continued PSA relapse-free survival. The only independent variable identified by a multivariate analysis to affect local relapse-free survival (LRFS) was a PSA-1 value greater than 1.0 to ≤ 4.0 ng/mL (P < .004), while high-grade histology (P < .0001) and local failure (P < .001) were the only significant variables to affect distant metastases-free survival (DMFS). Conclusion: Patients with PSA values ≤ 1.0 ng/mL are significantly less likely to have a subsequent relapse after therapy than those with levels greater than 1.0 to ≤ 4.0 ng/mL. Continuously maintained PSA levels of ≤ 1.0 ng/mL after treatment may serve as an end point for early evaluation of the efficacy of experimental radiotherapy protocols in prostate cancer.
Keywords: adult; cancer survival; treatment outcome; aged; disease-free survival; major clinical study; clinical trial; cancer radiotherapy; comparative study; follow up; follow-up studies; cancer grading; lymph node excision; adenocarcinoma; prostate specific antigen; proportional hazards models; tumor markers, biological; tumor marker; time factors; prostate-specific antigen; prostatic neoplasms; iodine 125; iodine radioisotopes; brachytherapy; multivariate analysis; prostate adenocarcinoma; serum; middle age; prognosis; human; male; priority journal; article
Journal Title: Journal of Clinical Oncology
Volume: 13
Issue: 2
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 1995-02-01
Start Page: 459
End Page: 463
Language: English
PUBMED: 7531221
PROVIDER: scopus
DOI: 10.1200/JCO.1995.13.2.459
DOI/URL:
Notes: Article -- Export Date: 28 August 2018 -- Source: Scopus
Altmetric Score
MSK Authors
  1. Zvi Fuks
    313 Fuks
  2. Michael J Zelefsky
    624 Zelefsky
  3. Steven A Leibel
    220 Leibel
  4. Kent E. Wallner
    29 Wallner