title: Risk-stratified survival rates and predictors of biochemical recurrence after radical prostatectomy in a Nara, Japan, cohort study.
abstract: BACKGROUND
  The aim of this study was to evaluate the oncological outcomes in patients who underwent radical prostatectomy in various risk groups.
  
  
  METHODS
  The subjects were 468 patients with clinically localized or locally advanced adenocarcinoma of the prostate (T1-3N0M0) who underwent retropubic radical prostatectomy with/without neoadjuvant and/or adjuvant therapy at Nara Medical University and its affiliated hospitals between January 1997 and December 2006. All patients were stratified by D'Amico risk classification. The independent predictor of biochemical recurrence was determined in each risk group.
  
  
  RESULTS
  Of all 468 patients, 171 patients showed biochemical recurrence during a mean follow-up period of 53 months. The 5-year estimated biochemical recurrence-free survival rates in the low, intermediate, and high-risk groups were 77.3, 71.3, and 46.3%, respectively. The multivariate analysis using Cox's proportional hazard model showed that patient age in the low-risk group, seminal vesicle involvement in the intermediate-risk group, and prostate-specific antigen value at diagnosis, surgical Gleason score, percent positive core, and perineural invasion in the high-risk group were independent predictors of biochemical recurrence.
  
  
  CONCLUSIONS
  The high-risk patients showed a significant higher biochemical recurrence than the low- and intermediate-risk patients. The independent predictor of biochemical recurrence was different in each risk group.
authors: Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan. sendo@naramed-u.ac.jp
authors: Nobumichi
authors: N
authors: Tanaka
authors: Kiyohide
authors: K
authors: Fujimoto
authors: Akihide
authors: A
authors: Hirayama
authors: Kazumasa
authors: K
authors: Torimoto
authors: Eijiro
authors: E
authors: Okajima
authors: Masahiro
authors: M
authors: Tanaka
authors: Makito
authors: M
authors: Miyake
authors: Keiji
authors: K
authors: Shimada
authors: Noboru
authors: N
authors: Konishi
authors: Yoshihiko
authors: Y
authors: Hirao
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000368:Aged; D015331:Cohort Studies; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D009367:Neoplasm Staging; D017430:Prostate-Specific Antigen / Q000032:analysis / Q000378:metabolism*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D017430:Prostate-Specific Antigen