Secondary Analysis of PSA and BCR-Free Survival in Asian Prostate Cancer Patients
Xin Gao,1,* Yijun Fu,1,* Zimei Mo,1 Yongtong Ruan2 1Department of Urology, Yangjiang Hospital of Traditional Chinese Medicine, Affiliated to Guangzhou University of Chinese Medicine, Yangjiang, Guangdong, People’s Republic of China; 2Department of Urology, Yangjiang Hospital...
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Dove Medical Press
2025-06-01
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| Series: | Cancer Management and Research |
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| Online Access: | https://www.dovepress.com/secondary-analysis-of-psa-and-bcr-free-survival-in-asian-prostate-canc-peer-reviewed-fulltext-article-CMAR |
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| author | Gao X Fu Y Mo Z Ruan Y |
| author_facet | Gao X Fu Y Mo Z Ruan Y |
| author_sort | Gao X |
| collection | DOAJ |
| description | Xin Gao,1,&ast; Yijun Fu,1,&ast; Zimei Mo,1 Yongtong Ruan2 1Department of Urology, Yangjiang Hospital of Traditional Chinese Medicine, Affiliated to Guangzhou University of Chinese Medicine, Yangjiang, Guangdong, People’s Republic of China; 2Department of Urology, Yangjiang Hospital of Traditional Chinese Medicine, Yangjiang, Guangdong, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yongtong Ruan, Department of Urology, Yangjiang Hospital of Traditional Chinese Medicine, Shiwan North Road, Jiangcheng District, Yangjiang, 529500, People’s Republic of China, Tel +86-13432578081, Email ruanyongtong@qq.comBackground: Prostate cancer remains a significant global health burden, with biochemical recurrence (BCR) affecting 20– 50% of patients post-radical prostatectomy. This study aimed to investigate the relationship between preoperative PSA levels and BCR-free survival in Asian populations.Methods: We conducted a retrospective cohort study of 3,092 prostate cancer patients who underwent radical prostatectomy at Yonsei University College of Medicine, Korea (1992– 2014). The exposure variable was preoperative PSA level, and the primary outcome was BCR-free survival. Covariates included age, Gleason score, pathological stage, surgical margins, and other clinical factors. Patients were followed quarterly for two years post-surgery, semi-annually for three years, then annually thereafter (median follow-up: 66 months).Results: Using piecewise linear regression, we identified a significant threshold effect at PSA 5.1 ng/mL. Above this threshold, each unit increase in LnPSA was associated with a 6.10-month reduction in BCR-free survival (95% CI: − 7.64 to − 4.56, P< 0.0001). Higher PSA levels correlated with increased adverse pathological features and shorter BCR-free survival across all risk groups.Conclusion: This study establishes a critical PSA threshold of 5.1 ng/mL for BCR risk stratification in Asian populations. Above this threshold, each unit increase in LnPSA correlates with a 6.10-month reduction in BCR-free survival, providing valuable guidance for post-operative monitoring and personalized treatment strategies.Keywords: prostate cancer, prostate-specific antigen, PSA, biochemical recurrence, nonlinearity |
| format | Article |
| id | doaj-art-d6c1f981f66648398e7e412aa9c073aa |
| institution | Kabale University |
| issn | 1179-1322 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Cancer Management and Research |
| spelling | doaj-art-d6c1f981f66648398e7e412aa9c073aa2025-08-20T03:32:35ZengDove Medical PressCancer Management and Research1179-13222025-06-01Volume 17Issue 112051214104133Secondary Analysis of PSA and BCR-Free Survival in Asian Prostate Cancer PatientsGao X0Fu Y1Mo Z2Ruan Y3urologyUrologyaffiliated Yangjiang Hospital of Traditional Chinese MedicineUrologyXin Gao,1,&ast; Yijun Fu,1,&ast; Zimei Mo,1 Yongtong Ruan2 1Department of Urology, Yangjiang Hospital of Traditional Chinese Medicine, Affiliated to Guangzhou University of Chinese Medicine, Yangjiang, Guangdong, People’s Republic of China; 2Department of Urology, Yangjiang Hospital of Traditional Chinese Medicine, Yangjiang, Guangdong, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yongtong Ruan, Department of Urology, Yangjiang Hospital of Traditional Chinese Medicine, Shiwan North Road, Jiangcheng District, Yangjiang, 529500, People’s Republic of China, Tel +86-13432578081, Email ruanyongtong@qq.comBackground: Prostate cancer remains a significant global health burden, with biochemical recurrence (BCR) affecting 20– 50% of patients post-radical prostatectomy. This study aimed to investigate the relationship between preoperative PSA levels and BCR-free survival in Asian populations.Methods: We conducted a retrospective cohort study of 3,092 prostate cancer patients who underwent radical prostatectomy at Yonsei University College of Medicine, Korea (1992– 2014). The exposure variable was preoperative PSA level, and the primary outcome was BCR-free survival. Covariates included age, Gleason score, pathological stage, surgical margins, and other clinical factors. Patients were followed quarterly for two years post-surgery, semi-annually for three years, then annually thereafter (median follow-up: 66 months).Results: Using piecewise linear regression, we identified a significant threshold effect at PSA 5.1 ng/mL. Above this threshold, each unit increase in LnPSA was associated with a 6.10-month reduction in BCR-free survival (95% CI: − 7.64 to − 4.56, P< 0.0001). Higher PSA levels correlated with increased adverse pathological features and shorter BCR-free survival across all risk groups.Conclusion: This study establishes a critical PSA threshold of 5.1 ng/mL for BCR risk stratification in Asian populations. Above this threshold, each unit increase in LnPSA correlates with a 6.10-month reduction in BCR-free survival, providing valuable guidance for post-operative monitoring and personalized treatment strategies.Keywords: prostate cancer, prostate-specific antigen, PSA, biochemical recurrence, nonlinearityhttps://www.dovepress.com/secondary-analysis-of-psa-and-bcr-free-survival-in-asian-prostate-canc-peer-reviewed-fulltext-article-CMARProstate cancer;Prostate-specific antigen (PSA)Biochemical recurrence;Nonlinearity. |
| spellingShingle | Gao X Fu Y Mo Z Ruan Y Secondary Analysis of PSA and BCR-Free Survival in Asian Prostate Cancer Patients Cancer Management and Research Prostate cancer;Prostate-specific antigen (PSA) Biochemical recurrence;Nonlinearity. |
| title | Secondary Analysis of PSA and BCR-Free Survival in Asian Prostate Cancer Patients |
| title_full | Secondary Analysis of PSA and BCR-Free Survival in Asian Prostate Cancer Patients |
| title_fullStr | Secondary Analysis of PSA and BCR-Free Survival in Asian Prostate Cancer Patients |
| title_full_unstemmed | Secondary Analysis of PSA and BCR-Free Survival in Asian Prostate Cancer Patients |
| title_short | Secondary Analysis of PSA and BCR-Free Survival in Asian Prostate Cancer Patients |
| title_sort | secondary analysis of psa and bcr free survival in asian prostate cancer patients |
| topic | Prostate cancer;Prostate-specific antigen (PSA) Biochemical recurrence;Nonlinearity. |
| url | https://www.dovepress.com/secondary-analysis-of-psa-and-bcr-free-survival-in-asian-prostate-canc-peer-reviewed-fulltext-article-CMAR |
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