Ji Eun Heo1, Jee Soo Park1, Jong Soo Lee1, Jongchan Kim1, Won Sik Jang1, Nam Hoon Cho2, Koon Ho Rha1, Young Deuk Choi1, Sung Joon Hong1, Won Sik Ham3. 1. Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea. 2. Department of Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea. 3. Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea. uroham@yuhs.ac.
Abstract
PURPOSE: To evaluate biochemical recurrence (BCR) risk in men with localized prostate cancer (PC) of pathological Gleason score (pGS) 8-10. Although such patients have low BCR-free survival (BCRFS) following radical prostatectomy (RP), they are not recommended for adjuvant radiation therapy (ART) as per current guidelines. METHODS: Among an adjuvant treatment-naïve cohort between 1995 and 2015, 1272 men were identified and categorized into group 1 [pGS7 (3 + 4) and pT3; n = 654], group 2 [pGS7 (4 + 3) and pT3; n = 408], and group 3 (pGS 8-10 and pT2; n = 210). The BCR risk of group 3 was compared with that of groups 1 and 2 who are the candidates for ART. RESULTS: At a median follow-up of 60 months (interquartile range: 39-86), 432 men experienced BCR. BCRFS was lower in group 3 than in groups 1 and 2 (p < 0.001 and p = 0.021, respectively). In multivariate analysis, this association persisted and surgical margin (SM) was found to be a significant BCR predictor. Although statistically not significant, BCRFS was lower in group 3 with positive SM (PSM) than in group 2 with PSM (p = 0.101). BCRFS was significantly worse in group 3 with negative SM (NSM) than in group 1 with PSM (p = 0.038), while it was better in group 2 with PSM (p = 0.297). CONCLUSION: Localized high-grade PC with PSM showed lower BCRFS and that with NSM showed better BCRFS without statistical significance than locally advanced GS 7 PC with PSM that are eligible for ART.
PURPOSE: To evaluate biochemical recurrence (BCR) risk in men with localized prostate cancer (PC) of pathological Gleason score (pGS) 8-10. Although such patients have low BCR-free survival (BCRFS) following radical prostatectomy (RP), they are not recommended for adjuvant radiation therapy (ART) as per current guidelines. METHODS: Among an adjuvant treatment-naïve cohort between 1995 and 2015, 1272 men were identified and categorized into group 1 [pGS7 (3 + 4) and pT3; n = 654], group 2 [pGS7 (4 + 3) and pT3; n = 408], and group 3 (pGS 8-10 and pT2; n = 210). The BCR risk of group 3 was compared with that of groups 1 and 2 who are the candidates for ART. RESULTS: At a median follow-up of 60 months (interquartile range: 39-86), 432 men experienced BCR. BCRFS was lower in group 3 than in groups 1 and 2 (p < 0.001 and p = 0.021, respectively). In multivariate analysis, this association persisted and surgical margin (SM) was found to be a significant BCR predictor. Although statistically not significant, BCRFS was lower in group 3 with positive SM (PSM) than in group 2 with PSM (p = 0.101). BCRFS was significantly worse in group 3 with negative SM (NSM) than in group 1 with PSM (p = 0.038), while it was better in group 2 with PSM (p = 0.297). CONCLUSION: Localized high-grade PC with PSM showed lower BCRFS and that with NSM showed better BCRFS without statistical significance than locally advanced GS 7 PC with PSM that are eligible for ART.
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