Interval from prostate biopsy to radical prostatectomy: Effect on PSA, Gleason sum, and risk of recurrence

Objectives. To determine whether the change in prostate-specific antigen (PSA), change in Gleason sum, and/or interval between prostate biopsy and radical prostatectomy have an association with biochemical recurrence. Methods. The relationship between biochemical recurrence and the interval between biopsy and surgery, as well as the rate and amount of change in PSA and Gleason sum from biopsy to surgery, was evaluated in 151 patients with prostate cancer treated with radical prostatectomy. Results. A statistically significant increase was found in PSA level and Gleason sum between biopsy and surgery (P = 0.01 and P <0.0001, respectively). No significant association was found between prebiopsy PSA level (P = 0.27) or biopsy Gleason sum (P = 0.07) with biochemical recurrence as independent variables or in a combined model (P = 0.12). An association was also not found between recurrence and preprostatectomy PSA level (P = 0.15) or the rate of PSA change (P = 0.28) as independent variables. However, a significant association was found with the prostatectomy Gleason sum (P = 0.001). In a combined model, a significant association was noted between the preprostatectomy PSA level and prostatectomy specimen Gleason sum and biochemical recurrence (P = 0.003). No increased risk of biochemical recurrence was noted with increasing time from biopsy to prostatectomy (odds ratio 1.00) or the rate (odds ratio 1.03) and degree (odds ratio 1.30) of serum PSA or Gleason sum (odds ratio 1.07). Conclusions. The interval between biopsy and radical prostatectomy is not a predictor of biochemical failure. An association was noted between an increased risk of biochemical failure and the amount of serum PSA and Gleason sum increase between biopsy and surgery.