67th Annual Meeting Abstracts

---

In Patients with Biochemical Recurrence Post-Prostatectomy, Early Recurrence and Faster PSA Doubling Time Predict for Metastatic Development
*Michael B Williams, *Bethany Barone, Paul F Schellhammer, Raymond S Lance
Eastern Virginia Medical School, Norfolk, VA

Introduction: Biochemical recurrence (BCR) following radical prostatectomy (RP) identifies patients at risk for metastases and death from prostate cancer. We hypothesize that patients with early BCR and faster PSADT have the highest risk of developing metastases and death.
Materials & Methods: All patients who received RP from 1989-2003 and developed BCR ≥ 0.2 formed the population. Primary endpoints were death and metastases. Cox proportional regression analysis was performed to calculate a hazard ratio for risk of metastasis and death.
Results: 206 patients with mean age of 61.5 years met the inclusion criteria with median follow-up of 93.7 months. RP specimens demonstrated ≥pT3 in 62.5%, Gleason≥7 in 50%, and EPE in 60%. Forty-nine percent received androgen deprivation prior to metastasis and 32% received salvage radiotherapy. With only ten events, no factors were associated with death. Metastatic disease was associated with pN+, time to BCR (<12mon v. >12mon), and not achieving an undetectable PSA post RP (30%). 10-year freedom from metastases based on time to BCR (<12mon v. >12mon) was 78.0% and 90.8%, respectively. PSADT <10 months had a 3.8 fold increased risk of developing metastases over a PSADT >10 months (p=0.002).
Conclusions: BCR within the first year after RP and PSADT <10 months increases the risk of developing metastases among patients with BCR. Remarkably, with 9-year median follow up and androgen deprivation in 49.5% prior to metastasis, only 15% of patients with BCR following RP developed metastases. All cause mortality was 4.8% and prostate cancer mortality was only 2.4%.

---