Table of Contents
ISRN Urology
Volume 2013, Article ID 984951, 5 pages
Clinical Study

Evaluating PSA Density as a Predictor of Biochemical Failure after Radical Prostatectomy: Results of a Prospective Study after a Median Follow-Up of 36 Months

Urology Department, Patras University Hospital, Building A, 4th Floor, Rion, 26500 Patras, Greece

Received 18 April 2013; Accepted 4 May 2013

Academic Editors: C. D. Lallas and D. Minardi

Copyright © 2013 Stavros Sfoungaristos and Petros Perimenis. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Purpose. To evaluate the predictive ability of PSA density for biochemical relapse after radical prostatectomy in patients operated for clinically localized disease and to compare its predictive strength with preoperative PSA and Gleason score. Patients and Methods. The study evaluated 244 patients with localized disease who underwent an open retropubic radical prostatectomy between February 2007 and April 2011. PSA was measured every 3 months after surgery with a mean follow-up period of 36 months. Two consecutive rises >0.2 ng/mL were considered as biochemical relapse. Results. Biochemical recurrence was observed in 71 (29.1%). A great correlation was found between relapse and PSA ( ), PSA density ( ), Gleason score ( ), pathological stage ( ), positive surgical margins ( ), and invasion of seminal vesicles ( ) and lymph nodes ( ). We also found that PSA density was associated with adverse pathological findings. In univariate and multivariate analysis both PSA ( ) and PSA density ( ) were found to be significant predictors for relapse in contrast to tumor grade. Conclusion. PSA density is a valuable parameter in estimating the danger of biochemical failure and it may increase predictive potential through the incorporation in preoperative nomograms.