Shintaro Narita1, Koji Mitsuzuka2, Norihiko Tsuchiya1, Takuya Koie3, Sadafumi Kawamura4, Chikara Ohyama3, Tatsuo Tochigi4, Takuhiro Yamaguchi5, Yoichi Arai2, Tomonori Habuchi1. 1. Department of Urology, Akita University Graduate School of Medicine, Akita, Japan. 2. Department of Urology, Tohoku University Graduate School of Medicine, Sendai, Japan. 3. Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan. 4. Department of Urology, Miyagi Cancer Center, Natori, Japan. 5. Department of Medical Sciences and Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan.
Abstract
OBJECTIVES: To assess the risk factors for biochemical recurrence in D'Amico intermediate-risk prostate cancer patients treated using radical prostatectomy. METHODS: We retrospectively reviewed the medical records of 1268 men with prostate cancer treated using radical prostatectomy without neoadjuvant therapy. The association between various risk factors and biochemical recurrence was then statistically evaluated. The Kaplan-Meier method, log-rank tests and Cox proportional hazards models were used for statistical analysis. RESULTS: In the intermediate-risk group, 96 patients (14.5%) experienced biochemical recurrence during a median follow up of 41 months. In the intermediate-risk group, preoperative prostate-specific antigen level, prostate volume and prostate-specific antigen density were significant preoperative risk factors for biochemical recurrence, whereas other factors including age, primary Gleason 4, clinical stage >T2 and percentage of positive biopsies were not. In multivariate analysis, higher preoperative prostate-specific antigen level and density, and a smaller prostate volume were independent risk factors for biochemical recurrence in the intermediate-risk group. Biochemical recurrence-free survival of patients in the intermediate-risk group with a higher prostate-specific antigen level and density (≥15 ng/mL, ≥0.6 ng/mL/cm(3), respectively), and lower prostate volume (≤10 mL) was comparable with that of high-risk group individuals (P = 0.632, 0.494 and 0.961, respectively). CONCLUSIONS: Preoperative prostate-specific antigen, prostate volume and prostate-specific antigen density are significant risk factors for biochemical recurrence in D'Amico intermediate-risk prostate cancer patients treated using radical prostatectomy. Using these variables, a subset of the intermediate-risk patients can be identified as having equivalent outcomes to high-risk patients.
OBJECTIVES: To assess the risk factors for biochemical recurrence in D'Amico intermediate-risk prostate cancerpatients treated using radical prostatectomy. METHODS: We retrospectively reviewed the medical records of 1268 men with prostate cancer treated using radical prostatectomy without neoadjuvant therapy. The association between various risk factors and biochemical recurrence was then statistically evaluated. The Kaplan-Meier method, log-rank tests and Cox proportional hazards models were used for statistical analysis. RESULTS: In the intermediate-risk group, 96 patients (14.5%) experienced biochemical recurrence during a median follow up of 41 months. In the intermediate-risk group, preoperative prostate-specific antigen level, prostate volume and prostate-specific antigen density were significant preoperative risk factors for biochemical recurrence, whereas other factors including age, primary Gleason 4, clinical stage >T2 and percentage of positive biopsies were not. In multivariate analysis, higher preoperative prostate-specific antigen level and density, and a smaller prostate volume were independent risk factors for biochemical recurrence in the intermediate-risk group. Biochemical recurrence-free survival of patients in the intermediate-risk group with a higher prostate-specific antigen level and density (≥15 ng/mL, ≥0.6 ng/mL/cm(3), respectively), and lower prostate volume (≤10 mL) was comparable with that of high-risk group individuals (P = 0.632, 0.494 and 0.961, respectively). CONCLUSIONS: Preoperative prostate-specific antigen, prostate volume and prostate-specific antigen density are significant risk factors for biochemical recurrence in D'Amico intermediate-risk prostate cancerpatients treated using radical prostatectomy. Using these variables, a subset of the intermediate-risk patients can be identified as having equivalent outcomes to high-risk patients.
Authors: Inmaculada Robles-Fernandez; Luis Javier Martinez-Gonzalez; Manrique Pascual-Geler; Jose Manuel Cozar; Ignacio Puche-Sanz; Maria Jose Serrano; Jose Antonio Lorente; Maria Jesus Alvarez-Cubero Journal: PLoS One Date: 2017-10-05 Impact factor: 3.240