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• W1965053728 abstract "No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Jun 2004PREDICTORS OF METASTATIC DISEASE IN MEN WITH BIOCHEMICAL FAILURE FOLLOWING RADICAL PROSTATECTOMY ONISURU T. OKOTIE, WILLIAM J. ARONSON, JEFF A. WIEDER, YEN LIAO, FRED DOREY, JEAN B. deKERNION, and STEPHEN J. FREEDLAND ONISURU T. OKOTIEONISURU T. OKOTIE More articles by this author , WILLIAM J. ARONSONWILLIAM J. ARONSON More articles by this author , JEFF A. WIEDERJEFF A. WIEDER More articles by this author , YEN LIAOYEN LIAO More articles by this author , FRED DOREYFRED DOREY More articles by this author , JEAN B. deKERNIONJEAN B. deKERNION More articles by this author , and STEPHEN J. FREEDLANDSTEPHEN J. FREEDLAND More articles by this author View All Author Informationhttps://doi.org/10.1097/01.ju.0000127734.01845.99AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We determined clinical and pathological predictors of positive bone scans and computerized tomography (CT) in patients with biochemical recurrence after radical prostatectomy (RP). Materials and Methods: A retrospective analysis of patients treated with RP at West Los Angeles Veterans Affairs Medical Center and University of California-Los Angeles Medical Center was performed to identify men with biochemical recurrence. All postoperative bone scans and pelvic CT following recurrence and prior to the initiation of hormone ablation therapy were reviewed. Preoperative clinical variables, pathological findings, serum prostate specific antigen (PSA) at postoperative imaging and postoperative PSA doubling time were compared between patients with positive and negative imaging study results. Results: A total of 128 patients with biochemical recurrence after RP who had postoperative pelvic CT or bone scans available were identified. A total of 97 bone scans were obtained, of which 11 (11%) were positive, and 71 CT scans were obtained, of which 5 (7%) were positive. Men with PSA doubling time less than 6 months were at increased risk of a positive bone scan (26% vs 3%) or positive CT (24% vs 0%) relative to men with longer PSA doubling time. In men with PSA doubling time less than 6 months the risk of a positive study highly depended on PSA at the time of imaging. In men with PSA less than 10 ng/ml the incidence of a positive study was 0% for pelvic CT and 11% for bone scan. In men with PSA greater than 10 ng/ml the risk of a positive study was 57% for pelvic CT and 46% for bone scan. In men with PSA doubling time greater than 6 months no clear relationship to PSA was seen, although the number of patients with a positive study was extremely low (positive bone scans 3% and positive CT 0%). However, none of the 6 imaging studies performed in men with PSA doubling times greater than 6 months and a markedly elevated PSA of 20 to 90 ng/ml was positive. Conclusions: The risk of detecting metastatic disease by bone scan or pelvic CT in men with biochemical recurrence following RP with PSA doubling time greater than 6 months is low despite marked PSA increases up to 90 ng/ml. In men with PSA doubling time less than 6 months the risk of detecting metastatic disease markedly increases when PSA is greater than 10 ng/ml. These results have important implications for the timing of imaging in patients with biochemical recurrence following RP. 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Google Scholar From the Departments of Urology (OTO, WJA, JAW, YL, JBdK) and Biostatistics (FD), University of California-Los Angeles School of Medicine and Department of Surgery, Veterans Administration Greater Los Angeles Healthcare System (WJA), Los Angeles, California, and Department of Urology, The Johns Hopkins School of Medicine (SJF), Baltimore, Maryland© 2004 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byMitchell C, Lowe V, Rangel L, Hung J, Kwon E and Karnes R (2018) Operational Characteristics of 11C-Choline Positron Emission Tomography/Computerized Tomography for Prostate Cancer with Biochemical Recurrence After Initial TreatmentJournal of Urology, VOL. 189, NO. 4, (1308-1313), Online publication date: 1-Apr-2013.Choueiri T, Dreicer R, Paciorek A, Carroll P and Konety B (2018) A Model That Predicts the Probability of Positive Imaging in Prostate Cancer Cases With Biochemical Failure After Initial Definitive Local TherapyJournal of Urology, VOL. 179, NO. 3, (906-910), Online publication date: 1-Mar-2008.Freedland S and Moul J (2018) Prostate Specific Antigen Recurrence After Definitive TherapyJournal of Urology, VOL. 177, NO. 6, (1985-1991), Online publication date: 1-Jun-2007.Freedland S, Humphreys E, Mangold L, Eisenberger M and Partin A (2018) Time to Prostate Specific Antigen Recurrence After Radical Prostatectomy and Risk of Prostate Cancer Specific MortalityJournal of Urology, VOL. 176, NO. 4, (1404-1408), Online publication date: 1-Oct-2006. Volume 171Issue 6 Part 1June 2004Page: 2260-2264 Advertisement Copyright & Permissions© 2004 by American Urological Association, Inc.Keywordsneoplasm metastasisprostatic neoplasmsprostatediagnostic imagingprostate-specific antigenMetricsAuthor Information ONISURU T. OKOTIE More articles by this author WILLIAM J. ARONSON More articles by this author JEFF A. WIEDER More articles by this author YEN LIAO More articles by this author FRED DOREY More articles by this author JEAN B. deKERNION More articles by this author STEPHEN J. FREEDLAND More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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