The clinical relevance of biochemical recurrence (BCR) after radical prostatectomy (RP) in ISUP Grade Group 1 prostate cancer is unclear. We evaluated the incidence of BCR, its pathological predictors, and long-term oncologic outcomes in this population.
Retrospective observational study of consecutive patients who underwent RP between 1999 and 2012 with ISUP GG 1 adenocarcinoma in the specimen. BCR was defined as PSA ≥ 0.2 ng/mL in two consecutive measurements after postoperative nadir. BCR-free survival and overall survival were estimated using Kaplan-Meier analysis, and predictors of BCR were identified using Cox regression. Salvage treatments, events of radiologic progression, and mortality were described.
A total of 208 patients were included. The median follow-up was 12.1 years. BCR was observed in 45 (21.6%), with a median time to BCR of 5.2 years (IQR 2.3-7.5). Five-year BCR-free survival was 92%, 81% at 10 years, and 78% at 15 years. Positive surgical margins were the only independent predictor of BCR (HR 3.27; 95% CI 1.64-6.53; p < 0.001). Eleven patients with BCR (24.4%) received salvage radiotherapy. Only 3 patients developed radiologic progression (1.4%); 42 deaths (20.2%) were recorded; none of them were cancer-specific deaths.
In ISUP grade group 1 prostate cancer treated with RP, BCR is relatively common but rarely associated with radiologic progression; no cancer-specific deaths were observed during long-term follow-up. Positive margins were associated with a higher risk of BCR.
Actas urologicas espanolas. 2026 Apr 01 [Epub ahead of print]
L Diéguez-Álvarez, A I Hernández Álvarez, J Panach-Navarrete, A Castelló Porcar, L Esteban Igual, J M Martínez-Jabaloyas
Department of Urology, University Clinical Hospital of Valencia, INCLIVA Biomedical Research Institute, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain. Electronic address: ., Department of Urology, University Clinical Hospital of Valencia, INCLIVA Biomedical Research Institute, Faculty of Medicine and Dentistry, University of Valencia, Valencia, España, München Klinik gGmbH, Munich, Germany., Department of Urology, University Clinical Hospital of Valencia, INCLIVA Biomedical Research Institute, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain.