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 th e rate of prostate-specific antigen (PSA) changes in prostate carcinoma. We retrospectively calculated PSA doubling times prior to surgery in 62 patie nts with prostate carcinoma. The calculated values were compared with final pathologic findings and with rates of PSA failure after surgery. PSA value s increased during the period of observation in 82.3% of the patients, wher eas 17.7% had levels that remained stable. The median calculated PSA doubli ng time in those with increasing levels was 25.8 months, with doubling time s 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 tha n 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 doubl ing times (P < 0.01). The calculated PSA doubling time prior to radical sur gery 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.