The aim of this study was to test the hypothesis that preoperative prostate health index (PHI) levels could help to predict early biochemical recurrence (BCR) in a contemporary population of patients with prostate cancer treated with robot-assisted radical prostatectomy (RARP).
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The study population consisted of 313 patients treated with RARP for clinically localized prostate cancer at a single institution between 2010 and 2011. Patients subjected to neoadjuvant or adjuvant therapies and patients with a follow-up of
Mean total prostate-specific antigen and mean PHI levels were 5.76ng/ml (interquartile range: 4.2-8.7) and 46.0 (35-62), respectively. Biopsy Gleason score was 6 in 173 (55.3%), 7 in 121 (38.7%), and≥8 in 19 (6.1%) patients. At final pathology, extracapsular extension was observed in 59 (18.8%), seminal vesicle invasion in 24 (7.7%), and lymph node invasion in 11 (3.5%) patients, whereas 228 (72.8%) patients had organ-confined disease. The 2-year BCR-free survival rate was 92.5% in the overall population and was 96.7% in patients with organ-confined disease. The most significant PHI cutoff value to discriminate between patients with and without BCR was 82. Specifically, the 2-year BCR-free survival rate was 97.7% in patients with a preoperative PHI level
Preoperative PHI levels may discriminate between patients who are at a high risk vs. low risk of BCR after RARP. External validation of our findings within a larger population with a longer follow-up time is needed.
Urol Oncol. 2015 Aug;33(8):337.e7-337.e14. doi: 10.1016/j.urolonc.2015.05.007. Epub 2015 Jun 6.
Lughezzani G1, Lazzeri M2, Buffi NM2, Abrate A2, Mistretta FA3, Hurle R2, Pasini L2, Castaldo L2, Zandegiacomo De Zorzi S2, Peschechera R2, Fiorini G2, Taverna G2, Casale P2, Guazzoni G2.
1Department of Urology, Humanitas Clinical and Research Center, Humanitas University, Rozzano, Milan, Italy.
2Department of Urology, Humanitas Clinical and Research Center, Humanitas University, Rozzano, Milan, Italy.
3Department of Urology, Università degli Studi di Milano, Fondazione IRCCS Ca׳ Granda, Ospedale Maggiore Policlinico, Milano, Italy.