Prediction of biochemical recurrence after radical prostatectomy. New tool for selecting candidates for adjuvant radiation therapy.

To design a risk summation to select patients for adjuvant radiation therapy after prostatectomy.

A retrospective study was conducted on 629 patients with localised prostate cancer (pN0-pNx) who were treated with prostatectomy and with a prostate-specific antigen (PSA) value <0.

2ng/mL at 2-3 months. Biochemical recurrence was defined as a PSA >0. 4ng/mL. A multivariate Cox regression analysis was performed. A score (0-2) was assigned according to the hazard ratio of the significant variables. The score summation defined the risk summation.

A total of 19. 7% of the patients were pT3, 24. 2% had a Gleason score ≥8, and 26. 3% had positive surgical margins. The median follow-up was 82 months. Some 26. 6% of the patients experienced biochemical recurrence. The identified prognostic variables independent of biochemical recurrence were a Gleason score =7 (4+3) (HR, 2. 01; P=. 008), a Gleason score ≥8 (HR, 3. 07; P 50% survival free of biochemical recurrence at 5 and 8 years. In contrast, the patients with a risk summation ≥3 had <44% survival free of biochemical recurrence.

The patients with a risk summation ≤2 did not benefit from adjuvant radiation therapy, while the patients with a risk summation ≥3 might benefit from adjuvant radiation therapy.

Actas urologicas espanolas. 2015 Sep 27 [Epub ahead of print]

F Herranz-Amo, R Molina-Escudero, G Ogaya-Pinies, D Ramírez-Martín, F Verdú-Tartajo, C Hernández-Fernández

Servicio de Urología, Hospital General Universitario Gregorio Marañón, Madrid, España.  Servicio de Urología, Hospital General Universitario Gregorio Marañón, Madrid, España. , Servicio de Urología, Hospital General Universitario Gregorio Marañón, Madrid, España. , Servicio de Urología, Hospital General Universitario Gregorio Marañón, Madrid, España. , Servicio de Urología, Hospital General Universitario Gregorio Marañón, Madrid, España. , Servicio de Urología, Hospital General Universitario Gregorio Marañón, Madrid, España.

PubMed

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