Korean J Urol.  2010 Dec;51(12):836-842.

Biochemical Recurrence-Free and Cancer-Specific Survival after Radical Prostatectomy at a Single Institution

• Kim SC
• Jeong I
• Song C
• Hong JH
• Kim CS
• Ahn H

Abstract

PURPOSE
To analyze the biochemical recurrence-free and cancer-specific survival after radical prostatectomy in a consecutive series of patients with prostate cancer.
MATERIALS AND METHODS
We retrospectively reviewed data for 1,822 patients who underwent radical prostatectomy with pelvic lymph node dissection at our institution between 1990 and 2009. After excluding 498 patients who were treated with neoadjuvant androgen deprivation therapy or who were followed up for < or =6 months, we included 1324 patients (mean age, 64.4 years; mean prostate-specific antigen [PSA] level, 12.3 ng/ml). We assessed patient age at the time of surgery, preoperative PSA concentration, biopsy and pathologic Gleason scores, pathologic stage, surgical margin status, disease progression, and survival.
RESULTS
The mean follow-up time was 40 months (range, 6-193 months). The 5- and 10-year biochemical recurrence-free survival rates were 73.2% and 66.2%, respectively, and the 10-year cancer-specific survival rate was 92.4%. The mean time from surgery to biochemical recurrence was 18 months. In the multivariate analysis, Gleason score (4+3 vs. 2-6, p=0.004; 8-10 vs. 2-6, p<0.001), pathologic stage (pT3a vs. pT2, p=0.001; pT3b-4 vs. pT2, p<0.001; pN1 vs. pT2, p<0.001), and resection margin status (p<0.001) were statistically significant predictors of biochemical recurrence, with only pathologic stage (pT3b-4 vs. pT2, p=0.006; pN1 vs. pT2, p=0.010) being a statistically significant predictor of cancer-specific survival.
CONCLUSIONS
Radical prostatectomy resulted in favorable cancer control in more than 70% of patients after 5 years and a low (<10%) cancer-specific mortality rate after 10 years. The factors predictive of biochemical recurrence were Gleason score, pathologic stage, and resection margin status.

Keyword

Prostatectomy; Prostatic neoplasms

MeSH Terms

Biopsy
Disease Progression
Follow-Up Studies
Humans
Lymph Node Excision
Multivariate Analysis
Neoplasm Grading
Prostate
Prostate-Specific Antigen
Prostatectomy
Prostatic Neoplasms
Recurrence
Retrospective Studies
Survival Rate
Prostate-Specific Antigen

Figure

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  FIG. 1 Biochemical recurrence-free and cancer-specific survival in patients after radical prostatectomy. BCRFS: biochemical recurrence-free survival, CSS: cancer-specific survival.

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  FIG. 2 Biochemical recurrence-free and cancer-specific survival after radical prostatectomy by clinicopathological factors. PSA: prostate-specific antigen.

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  FIG. 3 Biochemical recurrence-free survival in patients with insignificant prostate cancer according to age (≤60 years, ≥61 years).

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