Use of pretreatment prostate-specific antigen doubling time to predict outcome after radical prostatectomy

The objective of this study was to better understand the implications of the rate of prostate-specific antigen (PSA) changes in prostate carcinoma. We retrospectively calculated PSA doubling times prior to surgery in 62 patients with prostate carcinoma. The calculated values were compared with final pathologic findings and with rates of PSA failure after surgery. PSA values increased during the period of observation in 82.3% of the patients, whereas 17.7% had levels that remained stable. The median calculated PSA doubling time in those with increasing levels was 25.8 months, with doubling times less than or equal to 24 months observed in 37.1% of the patients. Stage pT3 disease was more common in patients with PSA doubling times of less than or equal to 36 months than in those with doubling times > 36 months (P = 0.02). Biochemical failure was more common in patients with rapid PSA doubling times (P < 0.01). The calculated PSA doubling time prior to radical surgery is significantly associated with the final pathologic findings. Early PSA failure is more common in patients with rapid PSA doubling times prior to radical surgery.