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Reassessment of the risk factors for biochemical recurrence in D'Amico intermediate‐risk prostate cancer treated using radical prostatectomy
Author(s) -
Narita Shintaro,
Mitsuzuka Koji,
Tsuchiya Norihiko,
Koie Takuya,
Kawamura Sadafumi,
Ohyama Chikara,
Tochigi Tatsuo,
Yamaguchi Takuhiro,
Arai Yoichi,
Habuchi Tomonori
Publication year - 2015
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.12898
Subject(s) - prostatectomy , medicine , prostate cancer , biochemical recurrence , prostate specific antigen , urology , prostate , proportional hazards model , oncology , cancer
Objectives To assess the risk factors for biochemical recurrence in D'Amico intermediate‐risk prostate cancer patients treated using radical prostatectomy. Methods We retrospectively reviewed the medical records of 1268 men with prostate cancer treated using radical prostatectomy without neoadjuvant therapy. The association between various risk factors and biochemical recurrence was then statistically evaluated. The Kaplan–Meier method, log–rank tests and Cox proportional hazards models were used for statistical analysis. Results In the intermediate‐risk group, 96 patients (14.5%) experienced biochemical recurrence during a median follow up of 41 months. In the intermediate‐risk group, preoperative prostate‐specific antigen level, prostate volume and prostate‐specific antigen density were significant preoperative risk factors for biochemical recurrence, whereas other factors including age, primary Gleason 4, clinical stage >T2 and percentage of positive biopsies were not. In multivariate analysis, higher preoperative prostate‐specific antigen level and density, and a smaller prostate volume were independent risk factors for biochemical recurrence in the intermediate‐risk group. Biochemical recurrence‐free survival of patients in the intermediate‐risk group with a higher prostate‐specific antigen level and density (≥15 ng/mL, ≥0.6 ng/mL/cm 3 , respectively), and lower prostate volume (≤10 mL) was comparable with that of high‐risk group individuals ( P = 0.632, 0.494 and 0.961, respectively). Conclusions Preoperative prostate‐specific antigen, prostate volume and prostate‐specific antigen density are significant risk factors for biochemical recurrence in D'Amico intermediate‐risk prostate cancer patients treated using radical prostatectomy. Using these variables, a subset of the intermediate‐risk patients can be identified as having equivalent outcomes to high‐risk patients.