Risk prediction models for biochemical recurrence after radical prostatectomy using prostate-specific antigen and Gleason score

Abstract

Many computer models for predicting the risk of prostate cancer have been developed including for prediction of biochemical recurrence (BCR). However, models for individual BCR free probability at individual time-points after a BCR free period are rare. Follow-up data from 1656 patients who underwent laparoscopic radical prostatectomy (LRP) were used to develop an artificial neural network (ANN) to predict BCR and to compare it with a logistic regression (LR) model using clinical and pathologic parameters, prostate-specific antigen (PSA), margin status (R0/1), pathological stage (pT), and Gleason Score (GS). For individual BCR prediction at any given time after operation, additional ANN, and LR models were calculated every 6 months for up to 7.5 years of follow-up. The areas under the receiver operating characteristic (ROC) curve (AUC) for the ANN (0.754) and LR models (0.755) calculated immediately following LRP, were larger than that for GS (AUC: 0.715; P = 0.0015 and 0.001), pT or PSA (AUC: 0.619; P always <0.0001) alone. The GS predicted the BCR better than PSA (P = 0.0001), but there was no difference between the ANN and LR models (P = 0.39). Our ANN and LR models predicted individual BCR risk from radical prostatectomy for up to 10 years postoperative. ANN and LR models equally and significantly improved the prediction of BCR compared with PSA and GS alone. When the GS and ANN output values are combined, a more accurate BCR prediction is possible, especially in high-risk patients with GS ≥7.

The prostate health index PHI predicts oncological outcome and biochemical recurrence after radical prostatectomy - analysis in 437 patients

“…In our final cohort with available 437 patients (95% of 460 operated men) and complete follow up after RP from 2001 to 2014 we first represent PHI as a prognostic biomarker based on long term data. While most patients develop a BCR within the first two years, some have a recurrence of up to five years after RP [ 25 ]. We believe that a sufficient prediction regarding a possible BCR can only be made after a median follow up of at least 5 years because the number of BCR cases in the years 5 to 10 after RP are relatively low and decreasing continuously [ 25 ].…”

“…While most patients develop a BCR within the first two years, some have a recurrence of up to five years after RP [ 25 ]. We believe that a sufficient prediction regarding a possible BCR can only be made after a median follow up of at least 5 years because the number of BCR cases in the years 5 to 10 after RP are relatively low and decreasing continuously [ 25 ]. The data of this study supports this since 83.2% are recurrence free after 5 years, 78.6% after 8 years and 77.2% are recurrence free after 10 years.…”

The positivity rate of 68Gallium-PSMA-11 ligand PET/CT depends on the serum PSA-value in patients with biochemical recurrence of prostate cancer

“…We aimed to evaluate the dependence of the PR on PSA level and PSA kinetics, and to identify the lowest PSA threshold that detects local, regional or systemic relapse of PC, using 68Ga-PSMA-11 PET/CT. We retrospectively analyzed PSA levels after primary therapy for PC as well as PSA levels at resubmission for BCR in a large cohort of patients taking the Gleason Score (GS is the world’s established PC grading system and used for the histopathological assessment of the glandular morphology of the prostate; since PC is often inconsistent and may have significantly different areas, two areas are generally assessed for GS; biologically significantly more aggressive tumors must be assumed in findings with GS 4+3=7b, 4+4=8, 4+5=9 and 5+4=9 [5, 11, 25]), determined after resection, and anti-androgen therapy ( AT) into account.…”

National Comprehensive Cancer Network (NCCN) risk classification in predicting biochemical recurrence after radical prostatectomy: a retrospective cohort study in Chinese prostate cancer patients

“…This was consistent with other studies. 15 16 Preoperative PSA level as a factor predicting BCR was validated in most of the available studies. In this study, we also confirmed that PSA level at diagnosis, as well as short-term PSA after RP, was a significant predictor of BCR and BCR-free survival after adjusting other potential factors.…”