To determine whether there are subsets of men with pathologic high-grade disease (Gleason 8-10) who have particularly high or low 2-year BCR risk after radical prostatectomy (RP) when stratified into groups based on combinations of pathologic features such as surgical margins (SM), extracapsular extension (ECE) and seminal vesicle invasion (SVI).
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We identified 459 patients treated with RP with pathologic Gleason 8-10 in the SEARCH database. Patients were stratified into 5 groups based on pathological characteristics - Group 1: men with negative surgical margins and no extracapsular extension (-SM/-ECE), Group 2 (+SM/-ECE), Group 3 (-SM/+ECE), Group 4 (+SM/+ECE), and Group 5: men with SVI (+SVI). Cox proportional hazards models and the log-rank test were used to compare BCR among the groups.
At 2-years post-RP, pathological group was significantly correlated with BCR (log-rank, p
In patients with high grade (Gleason 8-10) prostate cancer after RP, the presence of either positive SM, ECE, or SVI are all associated with an increased risk of early BCR with 2-year BCR risk of 50% or higher. On the contrary, men with organ-confined margin-negative disease have a very low risk of early BCR despite Gleason 8-10 disease. This article is protected by copyright. All rights reserved.
BJU international. 2015 Sep 09 [Epub ahead of print]
Sean Fischer, Daniel Lin, Ross M Simon, Lauren Howard, William J Aronson, Martha K Terris, Christopher J Kane, Christopher L Amling, Matt R Cooperberg, Stephen J Freedland, Adriana C Vidal
Division of Urology, Department of Surgery, Duke University School of Medicine, Durham, NC. , Department of Urology, University of Washington, Seattle, WA. , Division of Urology, Department of Surgery, Duke University School of Medicine, Durham, NC. , Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC. , Urology Section, Department of Surgery, Veterans Affairs Medical Center of Greater Los Angeles, Los Angeles. , Urology Section, Division of Surgery, Veterans Affairs Medical Center, Augusta, Georgia. , Division of Urology, Department of Surgery, University of California at San Diego Medical Center, San Diego, California. , Department of Urology, Oregon Health and Science University, Portland, Oregon. , Department of Urology, University of California at San Francisco, San Francisco, California. , Urology Section, Veterans Affairs Medical Center, Durham, NC. , Urology Section, Veterans Affairs Medical Center, Durham, NC.