Relationship of preoperative PSA velocity to histopathological findings in the surgical specimen and survival after radical prostatectomy

To assess whether PSA velocity (PSV) is related to pathological findings in surgical specimen, biochemical recurrence-free survival (BRFS), cancer-related survival (CRS), and overall survival (OS). A retrospective, prospective, observational cohort study on 265 patients with prostate cancer (PCa) who underwent radical prostatectomy (RP) from 2000 to 2008. PSAV was calculated arithmetically and by linear regression analysis, using PSA values obtained in the year prior to diagnosis. A multivariate logistic regression analysis was performed to detect variables associated to extracapsular disease (ECD). Variables related to BRFS, CRS, and OS were analyzed using Kaplan-Meier methods (PSAV ≤ 3 vs. >3ng/mL/year) and a multivariate Cox regression analysis. The ability of PSA velocity to predict BRFS, CRS, and OS was evaluated using the concordance index. Median follow-up was 56.16 months (9.14–106.75). Median PSAV was 0.65 and 0.63ng/mL/year using the arithmetic and regression methods respectively. ECD was detected in 74 specimens (27.92%), and biochemical recurrence in 50 patients (18.87%). Cancerrelated mortality occurred in 4 patients (1.52%) and overall mortality was 16 patients (6.08%). In the multivariate analysis, PSAV was not related to ECD, but was independently associated to BRFS (RR: 1.06, 95% CI: 1.02–1.13, p=0.008), CRS (RR: 1.22, 95% CI: 1.00–1.50, p=0.048), and OS (RR: 1.35, 95% CI: 1.18–1.55, p 3ng/ml/año) y multivariado de regresión de Cox. La capacidad de PSAV para predeci