Time-influencing factors for biochemical progression following radical prostatectomy

• Published in: Actas urológicas españolas (English ed.) 2011, Vol.35 (4), p.201-207
• Main Authors: Barba, J, Brugarolas, X, Tolosa, E, Rincón, A, Romero, L, Rosell, D, Robles, J.E, Zudaire, J.J, Berian, J.M, Pascual, J.I
• Format: Article
• Language: English
• Subjects: Biochemical progression; Factores de pronóstico; Prognostic factors; Progresión bioquímica; Prostatectomía radical; Radical prostatectomy; Urology
• ISSN: 2173-5786; 2173-5786
• DOI: 10.1016/S2173-5786(11)70051-8

Abstract Introduction We assessed the time-influencing clinical-pathological factors for biochemical progression of an equal series of patients from a single institution. Materials and methods Retrospective analysis of 278 patients with biochemical progression following prostatectomy. We considered biochemical progression to be PSA>0.4 ng/ml. We performed the trial using the Cox model (univariate and multivariate) and using the Student's t-test to compare averages. Results With a mean follow-up of 4 (±3 DE) years, the univariate study showed a mean until progression for the Gleason score 2–6 in the biopsy of 824days and 543 for the Gleason score 7–10 (p = 0.003). For negative surgical margins, the mean was 920 days and 545 for positive margins (p = 0.0001). In the case of a Gleason score 2–7 in the specimen, the mean was 806 days and 501 for a Gleason score 8–10 (p = 0.001). Lastly, the mean for the cases with Ki-67 negative in the specimen (10%) (p = 0.003). In the multivariate study, Ki-67 (OR 1.028; IC 95% 1–1.01; p = 0.0001) and Gleason score 8–10 (OR 1.62; IC 95% 1.5–2.45; p = 0.026) in the specimen, and initial PSA >10 ng/ml (OR 1.02; IC 95% 1.01–1.04; p = 0.0001) were independent variables. Using these variables, we designed a predictive model with three groups. The time until the progression of each group was 1,081, 551 and 218 days respectively. Conclusion The Gleason score 7–10 in the prostate biopsy, the presence of Ki-67, the positive margins and the Gleason score 8–10 in the specimen, and the initial PSA>10 ng/ ml are time-influencing factors until biochemical progression. Pathological Gleason score 8–10, PSA>10 ng/ml and Ki-67 are independent factors.