Predictors of biochemical recurrence of prostate cancer

Cover Page


Aim. To study the role of postoperative parameters in predicting the probability of development of biochemical recurrence in patients with prostate cancer with low pre-operative risk of its progression. Methods. 95 patients who underwent radical prostatectomy, were included in the study, the average age being 59.5±0.7 (44-76) years. The average levels of total and free prostate-specific antigen were 5.8±0.2 (1.71-9.9) and 1.03±0.07 (0.2-3.6) ng/ml respectively. Biochemical recurrence was defined as the level of prostate-specific antigen higher than 0.2 ng/ml after radical prostatectomy. Results. 8 (8.4%) patients during the follow-up period were diagnosed with biochemical recurrence. The average period to biochemical recurrence development was 45.8±6.7 (24-84) months. Pathomorphological examination revealed presence of tumor cells at surgical margin in 18 (18.9%) cases. Biochemical recurrence was diagnosed in 5 out of 77 (6.5%) patients with negative surgical margins and in 3 out of 18 (1.7%) patients with positive surgical margins. In our study, no correlation between the state of surgical margin and biochemical recurrence development was revealed (χ2=1.958; р=0.162). In the study group postoperative Gleason score was not prognostically significant as well (р=0.294). The average tumor volume in resected material was 11.8±1.0% (1-55%) of prostate volume (мм3). Extraprostatic extension was diagnosed in 10 (10.5%) cases. Results of univariate dispersion analysis of postoperative parameters revealed prognostic significance of tumor volume in removed specimen (р=0.007) and extracapsular extension (р=0.027). Conclusion. In our study we determined that tumor volume and extracapsular extention are independent risk factors for biochemical recurrence in prostate cancer patients with low pre-operative risk of disease progression.

F A Guliev

Author for correspondence.
National Center of Oncology Baku, Azerbaijan

  • Soulié M., Salomon L. Oncological outcomes of prostate cancer surgery. Prog. Urol. 2015; 25 (15): 1010-1027. doi: 10.1016/j.purol.2015.07.015.
  • Bott S.R. Management of recurrent disease after radical prostatectomy. Prostate Cancer Prostatic Dis. 2004; 7: 211-216. doi: 10.1038/sj.pcan.4500732.
  • Epstein J.I., Allsbrook W.C.Jr, Amin M.B. et al. The 2005 International Society of Urological Pathology (ISUP) Consensus conference on gleason grading of prostatic carcinoma. Am. J. Surg. Pathol. 2005; 29 (9): 1228-1242. doi: 10.1097/01.pas.0000173646.99337.b1.
  • Walz J., Chun F.K., Klein E.A. et al. Nomogram predicting the probability of early recurrence after radical prostatectomy for prostate cancer. J. Urol. 2009; 181: 601-607, discussion 607-8. doi: 10.1016/j.juro.2008.10.033.
  • Kinčius M., Matjošaitis A.J., Trumbeckas D. et al. Independent predictors of biochemical recurrence after radical prostatectomy: a single center experience. Central Eur. J. Urol. 2011; 64 (1): 21-25. doi: 10.5173/ceju.2011.01.art4.
  • Ün S., Türk H., Koca O. et al. Factors determining biochemical recurrence in low-risk prostate cancer patients who underwent radical prostatectomy. Turkish J. Urol. 2015; 41 (2): 61-66. doi: 10.5152/tud.2015.65624.
  • Alenda O., Ploussard G., Mouracade P. et al. Impact of the primary Gleason pattern on biochemical recurrence-free survival after radical prostatectomy: A single-centre cohort of 1,248 patients with Gleason 7 tumours. World J. Urol. 2011; 29: 671-676. doi: 10.1007/s00345-010-0620-9.
  • Jang W.S., Kim L.H., Yoon C.Y. et al. Effect of preoperative risk group stratification on oncologic outcomes of patients with adverse pathologic findings at radical prostatectomy. PLoS One. 2016; 11 (10): 1-11. doi: 10.1371/journal.pone.0164497.
  • Swindle P., Eastham J.A., Ohori M. et al. Do margins matter? The prognostic significance of positive surgical margins in radical prostatectomy specimens. J. Urol. 2008; 179: 47-51. doi: 10.1016/j.juro.2008.03.137.
  • Amling C.L., Blute M.L., Bergstralh E.J. et al. Long-term hazard of progression after radical prostatectomy for clinically localized prostate cancer: Continued risk of biochemical failure after five years. J. Urol. 2000; 164: 101-105. doi: 10.1016/S0022-5347(05)67457-5.
  • Ahove D.A., Hoffman K.E., Hu J.C. et al. Which patients with undetectable PSA levels five years after radical prostatectomy are still at risk of recurrence? Implications for a risk-adapted followup strategy. Urology. 2010; 76: 1201-1205. doi: 10.1016/j.urology.2010.03.092.
  • Budäus L., Isbarn H., Eichelberg C. et al. Biochemical recurrence after radical prostatectomy: multiplicative interaction between surgical margin status and pathological stage. J. Urol. 2010; 184 (4): 1341-1346. doi: 10.1016/j.juro.2010.06.018.
  • Kikuchi E., Scardino P.T., Wheeler T.M. et al. Is tumor volume an independent prognostic factor in clinically localized prostate cancer? J. Urol. 2004; 172: 508-511. doi: 10.1097/01.ju.0000130481.04082.1a.
  • Merrill M.M., Lane B.R., Reuther A.M. et al. Tumor volume does not predict for biochemical recurrence after radical prostatectomy in patients with surgical Gleason score 6 or less prostate cancer. Urology. 2007; 70: 294-298. doi: 10.1016/j.urology.2007.03.062.
  • Eichelberger L.E., Koch M.O., Ebel J.N. et al. Maximum tumor diameter is an independent predictor of prostate-specific antigen recurrence in prostate cancer. Modern Pathol. 2005; 18: 886-890. doi: 10.1038/modpathol.3800405.
  • Van Oort I.M., Witjes J.A., Kok D.E. et al. Maximum tumor diameter is not an independent prognostic factor in high risk localized prostate cancer. World J. Urol. 2008; 26: 237-241. doi: 10.1007/s00345-008-0242-7.
  • Nelson B.A., Shappell S.B., Change S.S. et al. Tumour volume is an independent predictor of prostate-specific antigen recurrence in patients undergoing radical prostatectomy for clinically localized prostate cancer. BJU Int. 2006; 97: 1169-1172. doi: 10.1111/j.1464-410X.2006.06148.x.
  • Anastasiou I., Tyritzis S.I., Adamakis I. et al. Prognostic factors identifying biochemical recurrence in patients with positive margins after radical prostatectomy. Int. Urol. Nephrol. 2011; 43: 715-720. doi: 10.1007/s11255-010-9859-8.
  • Godoy G., Tareen B.U., Lepor H. Site of positive surgical margins influences biochemical recurrence after radical prostatectomy. BJU Int. 2009; 104: 1610-1614. doi: 10.1111/j.1464-410X.2009.08688.x.


Abstract - 103

PDF (Russian) - 51

© 2017 Guliev F.A.

Creative Commons License

This work is licensed
under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Свидетельство о регистрации СМИ ЭЛ № ФС 77-70434 от 20 июля 2017 года выдано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор)