Percentage of positive biopsy cores, preoperative prostate-specific antigen (PSA) level, pT and Gleason score as predictors of PSA recurrence after radical prostatectomy: a multi-institutional outcome study in Japan.
OBJECTIVE
To evaluate the clinical outcome of radical prostatectomy (RP) in Japan, by retrospectively analysing the clinicopathological data in patients with clinical T1-T2 prostate cancer treated by RP, as there can be prostate-specific antigen (PSA) recurrence after RP in substantially many patients, and its character can differ according to ethnic group and/or country.


METHODS
We reviewed 1192 patients who had a RP from 1993 to 2002 with no neoadjuvant/adjuvant therapy and whose PSA level after RP decreased at least once to undetectable levels (<0.2 ng/mL). PSA recurrence was defined as > or = 0.20 ng/mL. The patient data were collected from the Urological Oncology Study Group, a subgroup of Japan Clinical Oncology Group.


RESULTS
The patients' median (range) age was 67 (47-83) years and their PSA level before RP was 8.7 (1.0-153) ng/mL. During the median follow-up of 45.6 months, 302 of the 1192 patients (25.3%) developed PSA recurrence. The median time to recurrence was 369 (61-2128) days after RP. A log-rank test showed that five significant clinicopathological factors were associated with PSA recurrence after RP: the percentage of prostate needle-biopsy cores with cancer, the biopsy Gleason score, PSA level before RP, pathological stage, and the Gleason score of the RP specimen (P < 0.001 for all). In multivariate analyses, the percentage of positive biopsy cores, PSA level before RP, pT and the Gleason score of the RP specimen were all independent significant predictors of PSA recurrence after RP in Japanese men.


CONCLUSIONS
The frequency of PSA recurrence after RP was 25.3% in Japan and the percentage of positive biopsy cores, PSA level before RP, pT and the Gleason score of the RP specimen were independent significant factors for PSA recurrence.
Yokomizo
Akira
A
Department of Urology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan.
Murai
Masaru
M
Baba
Shiro
S
Ogawa
Osamu
O
Tsukamoto
Taiji
T
Niwakawa
Masashi
M
Tobisu
Ken-Ichi
K
Kinukawa
Naoko
N
Naito
Seiji
S
D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000473:pathology; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000378:metabolism*; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome
D017430:Prostate-Specific Antigen