The Prognostic Factors of Biochemical Recurrence-Free Survival Following Radical Prostatectomy

Abstract

<br /> <strong><span style="font-size: small;">Objective: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">To evaluate outcomes, biochemical recurrence-free survival (BCRFS) and to identify parameters </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">influencing BCRFS of radical prostatectomy (RP) and bilateral pelvic lymph node dissection in a single-institution. </span></span><strong><span style="font-size: small;">Methods: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">A retrospective review of prostate cancer (PC) patients received RP was identified from the medical records. </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Data was collected from 2007 to 2016. 178 patients received RP were enrolled in a study. These patients were evaluated </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">on efficacy of RP by using prostate-specific antigen (PSA) to analyze BCRFS and compared with Gleason score, </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">pathologic staging, margin status and lymph node status with BCRFS. </span></span><strong><span style="font-size: small;">Results: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">The median follow up was 32.5 months </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">(n = 178). Sixty-nine patients had extracapsular extension on pathologic results whereas 93 patients were classified as </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">a high risk group. The median time for biochemical recurrence (BCR) was 22.3 months. The 3-year BCRFS in patients </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">with a Gleason score 6, 3+4, 4+3, 8 and 9-10 were 85.8%, 84.6%, 78.7%, 53.3% and 35.8% . Multivariate analysis </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">showed that extracapsular extension was independently associated with BCRFS. </span></span><strong><span style="font-size: small;">Conclusions: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">New group grading system indicates impact on BCRFS on univariate analysis but show negative impact on a multivariate Cox regression, only pathologic staging was independently associated with the cancer control outcome. </span></span>