Abstract

Objective: We retrospectively evaluated the relationship between preoperative prostate specific antigen (PSA), PSA density, free/total PSA ratio and unfavorable pathological features of surgical specimen and biochemical failure in patients with clinically localized prostate cancer who have undergone radical retropubic prostatectomy. 

Materials and methods: The study included 75 patients with clinically localized prostate cancer who have undergone radical retropubic prostatectomy and bilateral pelvic lymphadenectomy. Patients were divided into groups according to preoperative PSA densities (two groups as <15% and >15%) and free/total PSA ratios (three groups as <10%, 10-20% and >20%). Serum PSA levels of 0.2 ng/mL and higher were considered as biochemical failure after radical prostatectomy. The distribution of patients according to positive surgical margins, extracapsular extension, seminal vesicle involvement, perineural invasion, pathological stage, and postoperative biochemical failure were evaluated.

Results: The mean follow-up period after radical prostatectomy was 17.1±12.2 months. Unfavorable pathological features of surgical specimen were significantly related only with preoperative serum PSA level of >10 ng/mL (p<0.05). Biochemical failure was detected in 25.7% of patients during follow-up (n=18). The only significant parameter associated with biochemical failure was preoperative serum PSA level >15 ng/mL (p<0.05). 

Conclusion: Preoperative PSA level is still the most important parameter in the prediction of postoperative pathological stage and biochemical recurrence.