PSA doubling time (PSADT) ≤6 months to identify a subgroup of men with biochemically-recurrent prostate cancer (BRPC) after prostatectomy (RP) at highest risk of distant metastasis (dMET).

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Abstract
E16587Background: In patients with BRPC after RP, PSADT is the strongest determinant of metastasis-free and overall survival. Prior reports defined 4 broad PSADT subgroups that predicted MFS and OS (15 mo). Prostate cancer specific survival impacts OS when PSADT ≤9 mo. Treatment and clinical trials are often offered to these patients, but risk of dMET remains heterogeneous. We combined two large BRPC databases to further evaluate PSADT cut-points that may sub-stratify risk of dMET in patients with PSADT ≤9 mo and potential PSA thresholds associated with dMET. Methods: Of 31,296 men with RP from 1989-2014 found in the CPDR and Johns Hopkins, those with BRPC with PSADT ≤9 mo and no prior androgen deprivation were eligible for analysis. PSADT was categorized as ≤3.0, 3.01-6.0, and 6.01-9.0 mo. MFS was modeled with Kaplan Meier (KM) curves and multivariable Cox proportional hazards analysis. The most proximal PSA value within 12 mo prior to dMET was evaluated. Results: Of 2,289 men with BRPC a...