Negishi Takahito, Kuroiwa Kentarou, Hori Yoshifumi, Tomoda Toshihisa, Uchino Hiroshi, Tokuda Noriaki, Furubayashi Nobuki, Nagase Kei, Iwai Hidenori, Nakamura Motonobu
Department of Urology, National Hospital Organization Kyushu Cancer Center, Fukuoka.
Department of Urology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki.
Jpn J Clin Oncol. 2017 Mar 1;47(3):233-238. doi: 10.1093/jjco/hyw181.
To assess the characteristics of biochemical recurrence in the late period (>5 years after radical prostatectomy) and the differences in the predictors of biochemical recurrence in different periods, we conducted a multicenter retrospective study.
We reviewed 478 men who underwent radical prostatectomy for clinically localized prostate cancer. All of the patients were followed up for at least 5 years. The cohort was then divided into three groups; no recurrence group, recurrence <5 years after surgery group and recurrence ≥5 years after surgery group. The background characteristics of each group were compared using the χ2 test. A Cox multivariate regression analysis was performed to determine the predictors of biochemical recurrence in each period.
Biochemical recurrence occurred in 135 men. In 113 (84%) of the patients, biochemical recurrence occurred at <5 years after surgery; in 22 (16%), it occurred at ≥5 years after surgery. The proportion of men with a low preoperative prostate-specific antigen level was significantly larger in the latter group (P = 0.0023). A preoperative prostate-specific antigen level and a positive surgical margin were significant predictors of biochemical recurrence at <5 years after surgery (hazard ratio: 1.03 and 3.20). A positive surgical margin was also a significant predictor of biochemical recurrence at ≥5 years after surgery (hazard ratio: 3.03); however, a high preoperative prostate-specific antigen level was not.
Biochemical recurrence occurred at ≥5 years after surgery in 16% of the patients. A positive surgical margin predicted biochemical recurrence in both the early and late periods.
为评估根治性前列腺切除术后晚期（>5年）生化复发的特征以及不同时期生化复发预测因素的差异，我们开展了一项多中心回顾性研究。
我们回顾了478例因临床局限性前列腺癌接受根治性前列腺切除术的男性患者。所有患者均接受了至少5年的随访。然后将该队列分为三组：无复发组、术后<5年复发组和术后≥5年复发组。采用χ2检验比较每组的背景特征。进行Cox多因素回归分析以确定各时期生化复发的预测因素。
135例男性出现生化复发。其中113例（84%）患者在术后<5年出现生化复发；22例（16%）在术后≥5年出现生化复发。后一组术前前列腺特异性抗原水平低的男性比例显著更高（P = 0.0023）。术前前列腺特异性抗原水平和手术切缘阳性是术后<5年生化复发的显著预测因素（风险比：1.03和3.20）。手术切缘阳性也是术后≥5年生化复发的显著预测因素（风险比：3.03）；然而，术前前列腺特异性抗原水平高不是。
16%的患者在术后≥5年出现生化复发。手术切缘阳性在早期和晚期均预测生化复发。
