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 biochemical 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 following RP. We also sought to determine if there were racial differences in preoperative PSA velocity and doubling time. Methods. A total of 331 patients underwent RP at the West Los Angeles VA Medical Center between November 1991 and March 2000. Of these patients, 86 had two or more preoperative PSA values that were at least 12 months apart. Patients were analyzed to determine whether preoperative PSA velocity or doubling time was predictive of adverse pathologic features, including positive surgical margins, capsular penetration, seminal vesicle invasion, or biochemical recurrence. Additionally, PSA velocity and doubling time were compared 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 invasion (P > 0.30). In addition, there was no association between PSA velocity or 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 not predictors of biochemical recurrence following RP. There were no racial differences in preoperative PSA velocity (P = 0.715) or doubling time (P = 0.662). Conclusions. Neither preoperative PSA velocity nor doubling time was a predictor 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 Inc.