Predictive factors for biochemical recurrence after laparoscopic radical prostatectomy in patients with prostate cancer
10.3969/j.issn.1672-8467.2024.04.006
- VernacularTitle:腹腔镜前列腺癌根治性切除术后患者生化复发的预测因素
- Author:
Yong ZHAO
1
,
2
;
Yu QI
;
Hang WANG
;
Shuai JIANG
;
Guo-Hong SHI
;
Xu ZHANG
;
Jian-Ming GUO
;
Lei XU
Author Information
1. 福建省医科大学附属南平第一医院泌尿外科 南平 353000
2. 复旦大学附属中山医院泌尿外科 上海 200032
- Keywords:
laparoscopic;
radical prostatectomy(RP);
biochemical recurrence(BCR);
prostate cancer
- From:
Fudan University Journal of Medical Sciences
2024;51(4):494-504
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the predictors of biochemical recurrence after laparoscopic radical prostatectomy.Methods The study cohort consisted of 416 consecutive prostatecancer patients who underwent radical prostatectomy in Zhongshan Hospital,Fudan University between Jan 2016 and Jun 2018.No patient received adjuvant therapy until documented biochemical recurrence.Biochemical recurrence-free survival(BCRFS)was estimated using the Kaplan-Meier method.Univariable and multivariable Cox proportional hazards regression models were utilized to determine variables predictive of biochemical recurrence.Results The median follow-up period was 174 weeks(inter quartile range 133-209 weeks).The overall biochemical recurrence rate was 21.39%(88/416).The time to biochemical recurrence was(51.11±47.71)weeks.Until the end of follow-up,the biochemical recurrence rates were 10%(1/10),6.12%(3/49),16.41%(43/262)and 43.16%(41/95)for low-risk,medium-risk,high-risk and locally advanced prostate cancer,respectively.On multivariable analysis,tumor invasion of the seminal vesicles(HR:2.119,95%CI:1.154-3.891,P=0.016);Seminal vesicle invasion(HR:1.824,95%CI:1.034-3.220,P=0.038),Gleason score≥8(HR:2.746,95%CI:1.268-5.943,P=0.010),prostate-specific antigen(PSA)=10-20 ng/mL(HR:4.240,95%CI:2.550-7.050,P<0.001);PSA>20 ng/mL(HR:6.341,95%CI:3.296-12.202,P<0.001)were the main predictors of biochemical recurrence.Conclusion Laparoscopic radical prostatectomy provides effective control of biochemical recurrence during the mid-term follow-up period.Tumor invasion of the seminal vesicles,seminal vesicle invasion,GS≥8,PSA=10-20 ng/mL,PSA>20 ng/mL were important predictors of biochemical recurrence after radical prostatectomy.
