INTRODUCTION - High and very high-risk prostate cancers are tumors that display great variation in their progression, making their behaviour and consequent prognosis difficult to predict. We analyse preoperative and postoperative risk factors that could influence biochemical recurrence of these tumors.
FREE DAILY AND WEEKLY NEWSLETTERS OFFERED BY CONTENT OF INTEREST
Did you find this article relevant? Subscribe to UroToday-GUOncToday!
The fields of GU Oncology and Urology are advancing rapidly including new treatments, enrolling clinical trials, screening and surveillance recommendations along with updated guidelines. Join us as one of our subscribers who rely on UroToday as their must-read source for the latest news and data on drugs. Sign up today for blogs, video conversations, conference highlights and abstracts from peer-review publications by disease and condition delivered to your inbox and read on the go.
MATERIAL AND METHODS - We carried out univariate and multivariate analyses in an attempt to establish statistically significant preoperative (age, rectal examination, PSA, biopsy Gleason score, uni/bilateral tumor, affected cylinder percentage) and postoperative (pT stage, pN lymph node affectation, Gleason score, positive surgical margins, percentage of tumor affectation, perineural infiltration) risk factors, as well as their relationship with biochemical recurrence (PSA >0. 2 ng/mL).
RESULTS - We analysed 276 patients with high and very high-risk prostate cancer that were treated with laparoscopic radical prostatectomy (LRP) between 2003-2007, with a mean follow-up of 84 months. Incidence of biochemical recurrence is 37. 3%. Preoperative factors with the greatest impact on recurrence are suspicious rectal exam (OR 2. 2) and the bilateralism of the tumor in the biopsy (OR 1. 8). Among the postoperative factors, the presence of a LRP positive surgical margins (OR 3. 4) showed the greatest impact, followed by the first grade of the Gleason score (OR 3. 3).
CONCLUSIONS - The factor with the greatest influence on biochemical recurrence when it comes to surgery and high and very high-risk prostate cancer is the presence of a positive margin, followed by the Gleason score. Preoperative factors (PSA, biopsy Gleason score, rectal examination, number of affected cylinders) offered no guidance concerning the incidence of BCR.
Central European journal of urology. 2015 Sep 26 [Epub]
Alfredo Aguilera, Beatriz Bañuelos, Jesús Díez, Jose María Alonso-Dorrego, Jesus Cisneros, Javier Peña
Department of Urology, Hospital Universitario La Paz, Madrid, Spain. , Department of Urology, Hospital Universitario La Paz, Madrid, Spain. , Department of Urology, Hospital Universitario La Paz, Madrid, Spain. , Department of Urology, Hospital Universitario La Paz, Madrid, Spain. , Department of Urology, Hospital Universitario La Paz, Madrid, Spain. , Department of Urology, Hospital Universitario La Paz, Madrid, Spain.