PROGNOSTIC VALUE OF THE DYNAMICS OF PROSTATE-SPECIFIC ANTIGEN IN BLOOD PLASMA BEFORE PERFORMING RADICAL PROSTATECTOMY

Abstract

THE AIM of the investigation was to study the prognostic value of determination of the prostate-specific antigen (PSA) and its dynamics before performing radical prostatectomy (RPE) in patients with localized forms of cancer of the prostate. PATIENTS AND METHODS. Radical retropubic prostatectomy was made on 150 patients with localized forms of prostate cancer in the period from 1996 through 2003. Mean age of the patients was 61.5±0.4 years (from 49 to 71 years). An analysis of correlation between different clinic-laboratory factors and PSA in blood plasma of patients with prostate cancer was made both 3 months before RPE and just before it. After RPE all the patients were under observation and underwent control outpatient observation in 1, 3, 6, 12 months and later every year. The maximal period of postoperative follow-up was 5 years. RESULTS. Higher level of PSA was noted in patients with a high stage and degree of malignancy of the tumors by the Glison scale. More important prognostic information has not so much the preoperative level of PSA in blood plasma as its dynamics during 3 months before RPE. In particular, rapid growth of the PSA level in blood plasma before RPE (higher than 2.5 ng/ml during 3 months) points to a risk of early appearance of remote metastases. CONCLUSION. The evaluation of PSA level in blood plasma and its dynamics before RPE underlies the prognosis of outcomes of the surgical treatment of patients with prostate cancer and facilitates its optimization.