ABSTRACT
Prostate-specific antigen (PSA) failure following either radical prostatectomy (RP)1 or external beam radiation therapy (RT)2 for patients with clinically localized prostate cancer occurs in approximately 30-50% of cases within 10 years following treatment, and is a great source of anxiety for both patients and physicians. Therefore, in an attempt to identify patients at high risk of failure following RP or RT, investigators have developed pretreatment risk groups3 and nomograms4 based on the relative values of time to post-treatment PSA failure following RP or RT. Yet, for whom PSA failure predicts death from prostate cancer remains unanswered. The inability to answer this question has been attributed to inadequate power in databases because of relatively short follow-up and the protracted clinical course of prostate cancer, as well as the competing causes of mortality in this patient population5.
