title: Biochemical recurrence after radical prostatectomy: is the disease or the surgeon to blame?
abstract: OBJECTIVE
  The PSA recurrence develops in 27 to 53% within ten years after radical prostatectomy (RP). We investigated the factors (disease grade and stage or the surgeon's expertise,) more likely to influence biochemical recurrence in men post-radical prostatectomy for organ-confined prostate cancer by different surgeons in the same institution.
  
  
  METHODS
  A total of 510 patients that underwent radical prostatectomy were investigated retrospectively. Biochemical recurrence was defined as detection of a PSA level of ≥ 0.20 ng/mL by two subsequent measurements. The causes, which are likely to influence the development of PSA recurrence, were separated into two groups as those related to the disease and those related to the surgical technique.
  
  
  RESULTS
  Biochemical recurrence was detected in 23.5% (120 cases) of 510 cases. The parameters most likely to influence biochemical recurrence were: PSA level (p < 0.0001), T stage (p < 0.0001), the presence of extracapsular invasion prostate (p < 0.0001), Gleason scores (p = 0.042, p < 0.0001) and the presence of biopsy with perineural invasion (p = 0.03). The only surgical factor that demonstrated relevance was inadvertent capsular incision during the surgery that influenced the PSA recurrence (p < 0.0001).
  
  
  CONCLUSIONS
  The PSA recurrence was detected in 21.6% of patients who had been treated with radical prostatectomy within 5 years, which indicates that the parameters related to the disease and the patient have a pivotal role in the PSA recurrence.
authors.affiliation: Ege University Medical Faculty Department of Urology, Izmir, Turkey. adnan.simsir@ege.edu.tr
authors.forename: Adnan
authors.initials: A
authors.lastname: Sımsır
authors.forename: Cag
authors.initials: C
authors.lastname: Cal
authors.forename: Rashad
authors.initials: R
authors.lastname: Mammadov
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Cureklıbatır
authors.forename: Bulent
authors.initials: B
authors.lastname: Semercı
authors.forename: Gurhan
authors.initials: G
authors.lastname: Gunaydın
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002983:Clinical Competence; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000097:blood* / Q000209:etiology; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy / Q000009:adverse effects* / Q000379:methods; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D014572:Urology / Q000592:standards*
chemical_list: D017430:Prostate-Specific Antigen