Department of Urology, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey.
Department of Urology, University of Health Sciences, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.
J Invest Surg. 2022 Oct;35(10):1733-1738. doi: 10.1080/08941939.2022.2101165. Epub 2022 Jul 24.
Patients with high-risk prostate cancer (PCa) experience heterogeneous oncological outcomes. In this study, we assessed the patients who underwent an RP procedure because of high-risk prostate cancer in subgroups formed according to D'Amico criteria and analyzed the effects of these criteria on biochemical recurrence (BCR) after RP.
We retrospectively identified high-risk non-metastatic PCa patients who underwent RP between 2006 and 2020 in our hospital. Groups were formed as follows: group 1 consisted of those with an ISUP grade 4 - 5 biopsy, group 2 consisted of those with a clinical stage T2c, group 3 consisted of those with a tPSA level ≥ 20 ng/ml, and group 4 consisted of those with locally advanced disease. Survival analyses were made by Kaplan-Meier test and Log Rank test. A value <0.05 was accepted as statistically significant.
Of all patients, 61.8% were cured by only RP and 38.2% had recurrences. Rates of BCR were significantly different among groups ( = 0.003). In group 1, group 2, group 3, and group 4, BCR rates were 30.8%, 13%, 40.8%, and 70.6%, respectively. Mean BCR-free survival was 82.47 ± 11.64 months. In group 2, BCR-free survival was higher than that in group 3 and group 4 (1 = 0.020 and 2 = 0.001) and in group 1, BCR-free survival was higher than that in group 4 ( = 0.016). There was no significant difference between group 3 and 4 ( > 0.05).
Despite the developments in the imaging technology, an elevated tPSA level remains to be an important predictor for BCR-free survival.
患有高危前列腺癌（PCa）的患者具有不同的肿瘤学预后。在本研究中，我们根据 D'Amico 标准评估了因高危前列腺癌而行 RP 手术的患者，并分析了这些标准对 RP 后生化复发（BCR）的影响。
我们回顾性地确定了 2006 年至 2020 年期间在我院行 RP 的高危非转移性 PCa 患者。根据以下标准将患者分为以下几组：第 1 组为活检 ISUP 分级 4-5 级，第 2 组为临床分期 T2c，第 3 组为 tPSA 水平≥20ng/ml，第 4 组为局部进展性疾病。采用 Kaplan-Meier 检验和 Log Rank 检验进行生存分析。 值<0.05 被认为具有统计学意义。
所有患者中，61.8%的患者仅通过 RP 治愈，38.2%的患者出现复发。各组之间的 BCR 率有显著差异（ = 0.003）。在第 1 组、第 2 组、第 3 组和第 4 组中，BCR 率分别为 30.8%、13%、40.8%和 70.6%。平均 BCR 无复发生存率为 82.47±11.64 个月。在第 2 组中，BCR 无复发生存率高于第 3 组和第 4 组（1 = 0.020 和 2 = 0.001），高于第 1 组（ = 0.016）。第 3 组和第 4 组之间无显著差异（ > 0.05）。
尽管影像学技术不断发展，但升高的 tPSA 水平仍然是 BCR 无复发生存的重要预测因素。
