Impact of preoperative serum PSA level from 0 to 10 ng/ml on pathological findings and disease-free survival after radical prostatectomy

Bijan Shekarriz, Jyoti Upadhyay, Fernando J. Bianco, Marcos V. Tefilli, Rabi Tiguert, Edward L. Gheiler, David J. Grignon, J. Edson Pontes, David P. Wood

Research output: Contribution to journalArticle

17 Scopus citations


BACKGROUND. To determine the impact of various preoperative serum prostate specific antigen (PSA) levels in the range from 0.1 to 10 ng/ml on pathological stage and disease-free survival after radical prostatectomy. METHODS. We selected a cohort of 585 patients who underwent radical prostatectomy between 1991-1996 for clinically localized prostate cancer and presented with preoperative serum PSA levels from 0.1 to 10 ng/ml. RESULTS. Pathological organ-confined disease was present in 57.6% of patients. The rate of organ-confined disease decreased from an average of 85% for patients with a PSA value < 2 ng/ml, to 46.8% for patients with a PSA value > 7 ng/ml. We found statistically significant correlations between preoperative serum PSA level and overall pathological stage (P = 0.001), pathologically organ-confined disease (P = 0.001), margin positive rates (P = 0.001), extra prostatic extension (P = 0.001), and seminal vesicle invasion (P = 0.001). The overall disease-free survival rate was 87%, with a median follow up of 42.4 months. Disease free survival was significantly better for patients with PSA up to 4 ng/ml (P = 0.005). CONCLUSIONS. Our data suggests that PSA detection programs should strive to detect prostate cancer in men before the PSA level rises above 7 ng/ml. In addition, since patients with a PSA level < 4 ng/ml had better disease-free survival rates than those with a PSA level between 4.1-10 ng/ml, eliminating an arbitrary cutoff of 4 ng/ml, may lead to improved disease-free survival.

Original languageEnglish (US)
Pages (from-to)136-143
Number of pages8
Issue number3
StatePublished - Aug 22 2001


  • Organ confined disease
  • PSA
  • Pathological stage
  • Prognosis
  • Prostate cancer
  • Prostatic specific antigen
  • Radical prostatectomy
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Urology

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