Prognostic Factors of Castration-Resistant Prostate Cancer Among Patients With Localized Prostate Cancer Who Underwent Robot-Assisted Radical Prostatectomy in a Retrospective Multicenter Japanese Cohort (MSUG94)

IF 2.2 3区医学 Q3 UROLOGY & NEPHROLOGY

International Journal of Urology Pub Date : 2026-02-02 DOI:10.1111/iju.70370

Takeshi Sasaki, Atsushi Igarashi, Shin Ebara, Tomoyuki Tatenuma, Yoshinori Ikehata, Akinori Nakayama, Makoto Kawase, Masahiro Toide, Tatsuaki Yoneda, Kazushige Sakaguchi, Jun Teishima, Kazuhide Makiyama, Hiroshi Kitamura, Kazutaka Saito, Takuya Koie, Fumitaka Koga, Shinji Urakami, Toshinari Yamasaki, Takahiro Inoue

{"title":"Prognostic Factors of Castration-Resistant Prostate Cancer Among Patients With Localized Prostate Cancer Who Underwent Robot-Assisted Radical Prostatectomy in a Retrospective Multicenter Japanese Cohort (MSUG94)","authors":"Takeshi Sasaki, Atsushi Igarashi, Shin Ebara, Tomoyuki Tatenuma, Yoshinori Ikehata, Akinori Nakayama, Makoto Kawase, Masahiro Toide, Tatsuaki Yoneda, Kazushige Sakaguchi, Jun Teishima, Kazuhide Makiyama, Hiroshi Kitamura, Kazutaka Saito, Takuya Koie, Fumitaka Koga, Shinji Urakami, Toshinari Yamasaki, Takahiro Inoue","doi":"10.1111/iju.70370","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objectives</h3>\n \n <p>To explore clinicopathological risk factors associated with the development of castration-resistant prostate cancer (CRPC) in patients who underwent robot-assisted radical prostatectomy (RARP).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This study was conducted in nine Japanese institutions between 2012 and 2021. Patients with clinically metastatic PCa, those who received neoadjuvant or adjuvant therapy, were excluded. Consequently, 2825 patients with PCa were analyzed. Persistent prostate-specific antigen (PSA) was determined as a level ≥ 0.2 ng/mL at 1 month postoperatively and consistently in subsequent measurements.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Median follow-up was 42.0 months. Under follow-up, 493 (17.4%) and 25 (0.8%) patients progressed to biochemical recurrence and CRPC, respectively. One hundred and ninety-six patients received salvage radiation therapy, and 229 patients received salvage androgen deprivation therapy. Among the 25 patients with CRPC, the median time to CRPC was 31.8 months. Univariate analysis revealed that preoperative PSA level, biopsy grade group (GG) 5, percentage of positive cancer cores, GG5 in RARP specimens, pT3b, pN1, positive surgical margins, lymphovascular invasion (LVI), and persistent PSA levels were associated with CRPC development. Multivariate analysis revealed that biopsy GG5 (adjusted hazard ratio [aHR] 12.74, <i>p</i> < 0.001), LVI (aHR 3.90, <i>p</i> = 0.011), and persistent PSA levels (aHR 8.66, <i>p</i> < 0.001) were independently associated with CRPC development. Furthermore, using these three factors made it possible to stratify CRPC-free survival among patients with PCa who received RARP and confirmed external validation.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>The combination of biopsy GG5, LVI, and persistent PSA levels may stratify the risk of developing CRPC in patients with PCa undergoing RARP.</p>\n </section>\n </div>","PeriodicalId":14323,"journal":{"name":"International Journal of Urology","volume":"33 2","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12862882/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Urology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/iju.70370","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives

To explore clinicopathological risk factors associated with the development of castration-resistant prostate cancer (CRPC) in patients who underwent robot-assisted radical prostatectomy (RARP).

Methods

This study was conducted in nine Japanese institutions between 2012 and 2021. Patients with clinically metastatic PCa, those who received neoadjuvant or adjuvant therapy, were excluded. Consequently, 2825 patients with PCa were analyzed. Persistent prostate-specific antigen (PSA) was determined as a level ≥ 0.2 ng/mL at 1 month postoperatively and consistently in subsequent measurements.

Results

Median follow-up was 42.0 months. Under follow-up, 493 (17.4%) and 25 (0.8%) patients progressed to biochemical recurrence and CRPC, respectively. One hundred and ninety-six patients received salvage radiation therapy, and 229 patients received salvage androgen deprivation therapy. Among the 25 patients with CRPC, the median time to CRPC was 31.8 months. Univariate analysis revealed that preoperative PSA level, biopsy grade group (GG) 5, percentage of positive cancer cores, GG5 in RARP specimens, pT3b, pN1, positive surgical margins, lymphovascular invasion (LVI), and persistent PSA levels were associated with CRPC development. Multivariate analysis revealed that biopsy GG5 (adjusted hazard ratio [aHR] 12.74, p < 0.001), LVI (aHR 3.90, p = 0.011), and persistent PSA levels (aHR 8.66, p < 0.001) were independently associated with CRPC development. Furthermore, using these three factors made it possible to stratify CRPC-free survival among patients with PCa who received RARP and confirmed external validation.

Conclusions

The combination of biopsy GG5, LVI, and persistent PSA levels may stratify the risk of developing CRPC in patients with PCa undergoing RARP.

Abstract Image

查看原文本刊更多论文

日本多中心回顾性队列研究（MSUG94）：接受机器人辅助根治性前列腺切除术的局限性前列腺癌患者去势抵抗性前列腺癌的预后因素

目的：探讨机器人辅助根治性前列腺切除术（RARP）患者发生去势抵抗性前列腺癌（CRPC）的临床病理危险因素。方法：本研究于2012年至2021年在日本9家机构进行。临床转移性前列腺癌患者，接受新辅助或辅助治疗的患者，被排除在外。因此，我们分析了2825例PCa患者。持续性前列腺特异性抗原（PSA）在术后1个月测定为≥0.2 ng/mL，并在随后的测量中保持一致。结果：中位随访时间为42.0个月。随访中分别有493例（17.4%）和25例（0.8%）进展为生化复发和CRPC。196例患者接受补救性放射治疗，229例患者接受补救性雄激素剥夺治疗。在25例CRPC患者中，到CRPC的中位时间为31.8个月。单因素分析显示，术前PSA水平、活检分级组（GG） 5、癌核阳性百分比、RARP标本中GG5、pT3b、pN1、手术边缘阳性、淋巴血管浸润（LVI）和持续PSA水平与CRPC的发展相关。多因素分析显示，活检GG5（校正危险比[aHR] 12.74, p）、LVI和持续PSA水平的结合可对行RARP的PCa患者发生CRPC的风险进行分层。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

International Journal of Urology 医学-泌尿学与肾脏学

CiteScore

4.70

自引率

11.50%

发文量

340

审稿时长

3 months

期刊介绍： International Journal of Urology is the official English language journal of the Japanese Urological Association, publishing articles of scientific excellence in urology. Submissions of papers from all countries are considered for publication. All manuscripts are subject to peer review and are judged on the basis of their contribution of original data and ideas or interpretation.