After the removal of patients with DM , the difference between A1 and A2 BF persisted for OS ( P = .002 ) but not for DM ( P = .16 ) CONCLUSIONS : These results suggest that patients with rising PSA levels alone have less risk than those with A2 failures ; although DM was the largest contributor of adverse risk to A2 failure , it did not account for all excess risk in A2 failure .