Is PSA Still the Best Predictor for Biochemical Recurrence after Radical Prostatectomy in High-Risk Prostate Cancer?

IF 2.1 4区医学 Q2 SURGERY

Journal of Investigative Surgery Pub Date : 2022-10-01 Epub Date: 2022-07-24 DOI:10.1080/08941939.2022.2101165

Serkan Akan, Numan Doğu Güner, Caner Ediz, Aytaç Şahin, Ayhan Verit

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引用次数: 1

Abstract

Background: Patients with high-risk prostate cancer (PCa) experience heterogeneous oncological outcomes. In this study, we assessed the patients who underwent an RP procedure because of high-risk prostate cancer in subgroups formed according to D'Amico criteria and analyzed the effects of these criteria on biochemical recurrence (BCR) after RP.

Methods: We retrospectively identified high-risk non-metastatic PCa patients who underwent RP between 2006 and 2020 in our hospital. Groups were formed as follows: group 1 consisted of those with an ISUP grade 4 - 5 biopsy, group 2 consisted of those with a clinical stage T2c, group 3 consisted of those with a tPSA level ≥ 20 ng/ml, and group 4 consisted of those with locally advanced disease. Survival analyses were made by Kaplan-Meier test and Log Rank test. A P value <0.05 was accepted as statistically significant.

Results: Of all patients, 61.8% were cured by only RP and 38.2% had recurrences. Rates of BCR were significantly different among groups (P = 0.003). In group 1, group 2, group 3, and group 4, BCR rates were 30.8%, 13%, 40.8%, and 70.6%, respectively. Mean BCR-free survival was 82.47 ± 11.64 months. In group 2, BCR-free survival was higher than that in group 3 and group 4 (P1 = 0.020 and P2 = 0.001) and in group 1, BCR-free survival was higher than that in group 4 (P = 0.016). There was no significant difference between group 3 and 4 (P > 0.05).

Conclusion: Despite the developments in the imaging technology, an elevated tPSA level remains to be an important predictor for BCR-free survival.

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PSA仍然是高危前列腺癌根治性前列腺切除术后生化复发的最佳预测指标吗?

背景:高危前列腺癌(PCa)患者的肿瘤预后不同。在本研究中，我们根据D'Amico标准对高危前列腺癌行RP手术的患者进行分组，并分析这些标准对RP术后生化复发(BCR)的影响。方法:回顾性分析2006年至2020年间在我院行RP手术的高危非转移性PCa患者。分组如下:1组为ISUP 4 - 5级活检患者，2组为临床分期T2c患者，3组为tPSA水平≥20 ng/ml患者，4组为局部晚期患者。生存率分析采用Kaplan-Meier检验和Log Rank检验。结果:61.8%的患者仅行RP治愈率，38.2%的患者复发。各组间BCR率差异有统计学意义(P = 0.003)。组1、组2、组3、组4 BCR率分别为30.8%、13%、40.8%、70.6%。平均无bcr生存期为82.47±11.64个月。2组BCR-free生存率高于3、4组(P1 = 0.020, P2 = 0.001)， 1组BCR-free生存率高于4组(P = 0.016)。3、4组间差异无统计学意义(P > 0.05)。结论:尽管成像技术有了发展，tPSA水平升高仍然是无bcr生存的重要预测指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Investigative Surgery 医学-外科

CiteScore

4.20

自引率

0.00%

发文量

114

审稿时长

6-12 weeks

期刊介绍： Journal of Investigative Surgery publishes peer-reviewed scientific articles for the advancement of surgery, to the ultimate benefit of patient care and rehabilitation. It is the only journal that encompasses the individual and collaborative efforts of scientists in human and veterinary medicine, dentistry, basic and applied sciences, engineering, and law and ethics. The journal is dedicated to the publication of outstanding articles of interest to the surgical research community.