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Yang CK, Yang CR, Ou YC, Cheng CL, Ho HC, Chiu KY, Wang SS, Li JR, Chen CS, Hung CF, Chen CC, Wang SC, Lin CY, Hung SC. Prostate‑specific antigen density and preoperative MRI findings as predictors of biochemical recurrence in high‑risk and very high‑risk prostate cancer. Oncol Lett 2023; 26:284. [PMID: 37274483 PMCID: PMC10236138 DOI: 10.3892/ol.2023.13870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 01/18/2023] [Indexed: 06/06/2023] Open
Abstract
Patients with high-risk prostate cancer after prostatectomy have a particularly high chance of being diagnosed with biochemical recurrence (BCR). Patients with BCR have a greater risk of disease progression and mortality. The present retrospective observational study aimed to clarify the risk factors for the BCR of prostate cancer after radical prostatectomy in patients with high-risk and very high-risk prostate cancer. Patients diagnosed with prostate cancer who received radical prostatectomy in a single center from January 2009 to June 2020 were included in the study. Data from medical records were reviewed and the patients were followed up for ≥6 years. The primary outcome was BCR within 1 year after surgery. A total of 307 patients were included, with 187 in the high-risk group and 120 in the very high-risk group as classified by the National Comprehensive Cancer Network (NCCN) guidelines. Patients in the very high-risk group had a lower BCR-free survival rate compared with those in the high-risk group, with a high risk of BCR even if their PSA levels were initially undetectable after prostatectomy, and a high risk of postoperatively detectable PSA. In patients with undetectable PSA after prostatectomy, BCR was associated with the initial PSA density, imaging stage (T3aN0M0 and T3bN0M0), and pathologic stage (any N1). Postoperatively detectable PSA was associated with pathologic stage (T3bN0M0 and any N1) In conclusion, preoperative MRI imaging stage and PSA density are predictors for short-term BCR after prostatectomy. NCCN-defined high-risk patients with a high initial PSA density, imaging stage (T3aN0M0 and T3bN0M0), and pathologic stage (any N1) had a higher risk of BCR when compared with other patients with undetectable PSA, while those with pathologic stage (T3bN0M0 or any N1) displayed a higher risk of postoperatively detectable PSA. These findings may help urologists to identify patients for whom active therapeutic protocols are necessary.
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Affiliation(s)
- Cheng-Kuang Yang
- Department of Surgery, Division of Urology, Taichung Veterans General Hospital, Taichung 40705, Taiwan, R.O.C
| | - Chi-Rei Yang
- Department of Urology, China Medical University Hospital, Taichung 404332, Taiwan, R.O.C
| | - Yen-Chuan Ou
- Department of Urology, Tungs' Taichung Metro Harbor Hospital, Taichung 43503, Taiwan, R.O.C
| | - Chen-Li Cheng
- Department of Surgery, Division of Urology, Taichung Veterans General Hospital, Taichung 40705, Taiwan, R.O.C
| | - Hao-Chung Ho
- Department of Surgery, Division of Urology, Taichung Veterans General Hospital, Taichung 40705, Taiwan, R.O.C
| | - Kun-Yuan Chiu
- Department of Surgery, Division of Urology, Taichung Veterans General Hospital, Taichung 40705, Taiwan, R.O.C
| | - Shian-Shiang Wang
- Department of Surgery, Division of Urology, Taichung Veterans General Hospital, Taichung 40705, Taiwan, R.O.C
| | - Jian-Ri Li
- Department of Surgery, Division of Urology, Taichung Veterans General Hospital, Taichung 40705, Taiwan, R.O.C
| | - Chuan-Shu Chen
- Department of Surgery, Division of Urology, Taichung Veterans General Hospital, Taichung 40705, Taiwan, R.O.C
| | - Chi-Feng Hung
- Department of Surgery, Division of Urology, Taichung Veterans General Hospital, Taichung 40705, Taiwan, R.O.C
| | - Cheng-Che Chen
- Department of Surgery, Division of Urology, Taichung Veterans General Hospital, Taichung 40705, Taiwan, R.O.C
| | - Shu-Chi Wang
- Department of Surgery, Division of Urology, Taichung Veterans General Hospital, Taichung 40705, Taiwan, R.O.C
| | - Chia-Yen Lin
- Department of Surgery, Division of Urology, Taichung Veterans General Hospital, Taichung 40705, Taiwan, R.O.C
| | - Sheng-Chun Hung
- Department of Surgery, Division of Urology, Taichung Veterans General Hospital, Taichung 40705, Taiwan, R.O.C
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Madendere S, Türkkan G, Arda E, Yürüt Çaloğlu V, Kuyumcuoğlu U. Evaluation of Risk Groups for the Prediction of Biochemical Progression in Patients Undergoing Radical Prostatectomy. JOURNAL OF UROLOGICAL SURGERY 2022. [DOI: 10.4274/jus.galenos.2021.2021.0098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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