Preoperative PSA accurately measures cancer recurrence

Preoperative PSA remains an accurate measure of cancer recurrence, according to a study from Columbia University Medical Center and New York-Presbyterian Hospital. The study's authors say it refutes claims to the contrary.

Investigators followed 1,246 prostate cancer patients who underwent radical retropubic prostatectomy with no adjuvant therapy between 1988 and 2003. When controlling for cancer stage and grade (Gleason sum and pathologic stage), preoperative PSA was an accurate predictor of biochemical failure, regardless of when the operation was performed.

Using a concordance index, the accuracy of PSA in predicting outcome, stratified by time period in which the procedure was performed, was statistically equivalent: .65 for the period 1988 to 1993, .66 for the period 1994 to 1998, and .64 for the period 1999 to 2003, researchers reported at the AUA annual meeting.

"Contrary to other recent interpretations, our analysis finds that PSA remains a vital tool for determining risk of recurrence in prostate cancer patients — indeed, the predictive ability of the PSA test does not significantly vary over the last 15 years," said Mitchell C. Benson, MD, of New York-Presbyterian/Columbia.