PURPOSE: Using conditional survival (CS) analysis, we investigated whether the duration of survival without biochemical recurrence (BCR) of prostate cancer after laparoscopic radical prostatectomies (LRP) affected the BCR rate. We also investigated the impact of well-known risk factors for BCR. METHODS: Between 2002 and 2014, 627 consecutive patients underwent LRPs at our institution. Prostate-specific antigen (PSA) concentrations above 0.2 ng/mL were defined as BCR. Conditional BCR-free survival rates were determined through Kaplan-Meier analysis. Assessment of potential BCR risk factors was performed using a Cox proportional hazard analysis. RESULTS: The 10-year BCR-free rates after LRP increased to 82.4%, 84.5%, 86.6%, 90.1%, and 94.7% in patients surviving 1, 2, 3, 5, and 7.5 years without BCR, respectively. Multivariate analyses of age, PSA concentrations, neoadjuvant therapy, and pathological findings were performed for all patients. In all patients, positive surgical margins (PSM) and Gleason Grade Groups (GG) ≥ 4 were independent risk factors for BCR (p < 0.001, hazard ratio [HR] = 2.45; and p < 0.001, HR = 2.83, respectively,). Similarly, PSM and GG ≥ 4 were significant risk factors in patients surviving 1-5 years without BCR. No clear risk factors were observed in patients surviving > 5 years without BCR after LRPs. CONCLUSIONS: The BCR-free rate increased with time after LRP. It is recommended that patients with PSM, GG ≥ 4, or with both factors are strictly monitored for 5 years postoperatively. CS analysis is particularly useful for predicting the postoperative course of patients.
PURPOSE: Using conditional survival (CS) analysis, we investigated whether the duration of survival without biochemical recurrence (BCR) of prostate cancer after laparoscopic radical prostatectomies (LRP) affected the BCR rate. We also investigated the impact of well-known risk factors for BCR. METHODS: Between 2002 and 2014, 627 consecutive patients underwent LRPs at our institution. Prostate-specific antigen (PSA) concentrations above 0.2 ng/mL were defined as BCR. Conditional BCR-free survival rates were determined through Kaplan-Meier analysis. Assessment of potential BCR risk factors was performed using a Cox proportional hazard analysis. RESULTS: The 10-year BCR-free rates after LRP increased to 82.4%, 84.5%, 86.6%, 90.1%, and 94.7% in patients surviving 1, 2, 3, 5, and 7.5 years without BCR, respectively. Multivariate analyses of age, PSA concentrations, neoadjuvant therapy, and pathological findings were performed for all patients. In all patients, positive surgical margins (PSM) and Gleason Grade Groups (GG) ≥ 4 were independent risk factors for BCR (p < 0.001, hazard ratio [HR] = 2.45; and p < 0.001, HR = 2.83, respectively,). Similarly, PSM and GG ≥ 4 were significant risk factors in patients surviving 1-5 years without BCR. No clear risk factors were observed in patients surviving > 5 years without BCR after LRPs. CONCLUSIONS: The BCR-free rate increased with time after LRP. It is recommended that patients with PSM, GG ≥ 4, or with both factors are strictly monitored for 5 years postoperatively. CS analysis is particularly useful for predicting the postoperative course of patients.
Authors: Stephen A Boorjian; James A Eastham; Markus Graefen; Bertrand Guillonneau; R Jeffrey Karnes; Judd W Moul; Edward M Schaeffer; Christian Stief; Kevin C Zorn Journal: Eur Urol Date: 2011-12-07 Impact factor: 20.096
Authors: Yuhree Kim; Aslam Ejaz; Gaya Spolverato; Malcolm H Squires; George Poultsides; Ryan C Fields; Mark Bloomston; Sharon M Weber; Konstantinos Votanopoulos; Alexandra W Acher; Linda X Jin; William G Hawkins; Carl Schmidt; David Kooby; David Worhunsky; Neil Saunders; Clifford S Cho; Edward A Levine; Shishir K Maithel; Timothy M Pawlik Journal: Ann Surg Oncol Date: 2014-10-07 Impact factor: 5.344
Authors: John A Brockman; Shaheen Alanee; Andrew J Vickers; Peter T Scardino; David P Wood; Adam S Kibel; Daniel W Lin; Fernando J Bianco; Danny M Rabah; Eric A Klein; Jay P Ciezki; Tianming Gao; Michael W Kattan; Andrew J Stephenson Journal: Eur Urol Date: 2014-10-06 Impact factor: 20.096
Authors: Carmen V Leitner; Ines A Ederer; Michela de Martino; Sebastian L Hofbauer; Ilaria Lucca; Aurélie Mbeutcha; Romain Mathieu; Andrea Haitel; Martin Susani; Shahrokh F Shariat; Tobias Klatte Journal: J Urol Date: 2016-02-02 Impact factor: 7.450
Authors: Wooil Kim; Ho Yun Lee; Sin-Ho Jung; Min-Ah Woo; Hong Kwan Kim; Yong Soo Choi; Jhingook Kim; Jae Ill Zo; Young Mog Shim; Joungho Han; Ji Yun Jeong; Joon Young Choi; Kyung Soo Lee Journal: Oncotarget Date: 2017-05-09