Factors determining biochemical recurrence in low-risk prostate cancer patients who underwent radical prostatectomy

Abstract

Objective: This study was conducted to research the factors determining biochemical recurrence (BCR) in low-risk localized prostate cancer patients who underwent radical prostatectomy (RP). Material and methods:We retrospectively analyzed the data of 504 patients who had undergone RP between 2003 and 2013 at our clinic. One hundred and fifty-two patients who underwent RP for low-risk prostate cancer were included in the study. Results:The mean follow-up period for patients was 58.7 (21-229) months. The mean age of the patients was 63.7±7.2 years (49-79). The mean prostate specific antigen (PSA) value was 5.25±4.22 ng/mL (3.58-9.45). The BCR rate after the operation was 25% (38/152). In the univariate analysis, recurrence determining factors were shown to include extracapsular involvement (ECI) (p= 0.004), capsular invasion (CI) (p= 0.001), age (p= 0.014), and tumor size (p= 0.006). However, only CI was found to be significant in multivariate analysis (p= 0.001). Conclusion:Capsular invasion is an independent risk factor in low-risk prostate cancer patients who underwent RP for BCR.

<p>Prognostic significance of a novel indicator (PSA_postd3/PSA_pre) for PSA recurrence in patients after radical prostatectomy</p>

“…Yossepowitch et al concluded in a review in 2014 that positive margins were associated with a twofold increased hazard of biochemical relapse 22. Other previously investigated pathological indicators include capsule invasion,20 extracapsular extension,13,20 lymph node invasion,15,19 and seminal vesicle invasion 18,20. In our study, several possible prognostic factors besides postoperative PSA were also investigated.…”

“…3) Pathological T stage: Generally, a higher T stage suggests a greater probability of developing PSA recurrence 7,12,14–16. 4) Age: According to Wang et al, patients older than 70 years old were less likely to undergo PSA recurrence than those who were younger,12 although most other studies have reported an insignificant relationship between age and PSA recurrence 7,14,16,20,21. 5) Positive surgical margin: The prognostic value of PSM has been controversial 7,14,15,17,19,20.…”

“…4) Age: According to Wang et al, patients older than 70 years old were less likely to undergo PSA recurrence than those who were younger,12 although most other studies have reported an insignificant relationship between age and PSA recurrence 7,14,16,20,21. 5) Positive surgical margin: The prognostic value of PSM has been controversial 7,14,15,17,19,20. Yossepowitch et al concluded in a review in 2014 that positive margins were associated with a twofold increased hazard of biochemical relapse 22.…”

The efficiency of prostate-specific antigen density measurement using three different methods on the prediction of biochemical recurrence

“…Prediction of BCR in early phases after surgical treatments may provideinsight about the application timings of adjuvant or salvage treatments [16,18]. It was shown that different markers of many preop or postop periods-such as PSA, age, Gleason score, and clinical stage-are independent markers for recurrence-free survival [19,20]. Conflicting information on the fact that PSAD valuesare a predictive factor for BCR is seen despite completed studies [5,16].…”

Proton therapy- the modality of choice for future radiation therapy management of Prostate Cancer?

“…The cost per QALY data for both a 60 and 70 year old man are outlined in Table 4. From this, PR may be cost effective for younger patients, due to their longer life expectancy [49] as studies have shown that such patients are more likely to experience recurrence [91,92]. In addition, recent evidence has shown that PR can significantly decrease the risk of long term secondary malignancies [93] compared to that of IMRT; however this still remains controversial [94].…”