Preoperative PSA velocity and doubling time do not predict adverse pathologic features or biochemical recurrence after radical prostatectomy

Objectives. To improve the accuracy of predicting pathologic stage and bioc hemical recurrence after radical prostatectomy (RP), we sought to determine whether preoperative prostate-specific antigen (PSA) velocity and doubling time predict adverse pathologic features or biochemical recurrence followi ng RP. We also sought to determine if there were racial differences in preo perative PSA velocity and doubling time. Methods. A total of 331 patients underwent RP at the West Los Angeles VA Me dical Center between November 1991 and March 2000. Of these patients, 86 ha d two or more preoperative PSA values that were at least 12 months apart. P atients were analyzed to determine whether preoperative PSA velocity or dou bling time was predictive of adverse pathologic features, including positiv e surgical margins, capsular penetration, seminal vesicle invasion, or bioc hemical recurrence. Additionally, PSA velocity and doubling time were compa red among white, black, Hispanic, and Asian men. Results. Preoperative PSA velocity and doubling time were not predictive of positive surgical margins, capsular penetration, or seminal vesicle invasi on (P > 0.30). In addition, there was no association between PSA velocity o r doubling time and pathologic stage or surgical Gleason score (P > 0.36). Preoperative PSA velocity (P = 0.581) and doubling time (P = 0.528) were no t predictors of biochemical recurrence following RP. There were no racial d ifferences in preoperative PSA velocity (P = 0.715) or doubling time (P = 0 .662). Conclusions. Neither preoperative PSA velocity nor doubling time was a pred ictor of adverse pathologic findings or biochemical recurrence after RP, In addition, there was no difference in PSA velocity or doubling time between the races studied. UROLOGY 57: 476-480, 2001. (C) 2001, Elsevier Science I nc.