title: Survival analysis of patients with biochemical relapse after radical prostatectomy treated with androgen deprivation: Castration-resistance influential factors.
abstract: BACKGROUND
  We evaluate the prognosis of patients with biochemical recurrence (BCR) treated with androgen deprivation therapy (ADT) and to determine the influential factors to castration resistance (CR) and death.
  
  
  METHODS
  From a series of 1310 patients with T1-T2 prostate cancer treated with radical prostatectomy between 1989 and 2012, 371 had BCR. Patients with lymph node involvement were excluded. We analyzed only the 159 treated with salvage ADT. At the end of the study, 77 (48%) had developed CR.
  
  
  RESULTS
  The median follow-up to CR was 9.2 years. The CR-resistant free survival (RFS) was 76 ± 3%, 62 ± 3% and 43 ± 9% in 5, 10 and 15 years, respectively. The RFS median time was 14 years. In the multivariate study, the prostate-specific antigen (PSA) doubling time (PSA-DT) was <6 months (p = 0.01) (hazard ratio [HR] 3; 95% confidence interval [CI] 1.4-6.8, p = 0.007); seminal vesicle involvement (HR 3.1; 95% CI 1.5-6.2, p = 0.01) and PSA velocity in ng/mL/year (HR 1.3; 95% CI 1.1-1.5, p = 0.002) with better cut-off points of 0.84 ng/mL/year (p = 0.04) (HR 4; 95% CI 1.7-9.4, p = 0.001) were influential variables. Specific survival (SS) at 5, 10 and 15 years since surgery was 96 ± 1, 85 ± 2 and 76 ± 4, respectively. The time of CR to death was 30 ± 6% at 5 years, with the median at 3.2 years. In the multivariate only Ki 67 (HR 1.04; 95% CI 1.005-1.08, p = 0.02) had an independent influence.
  
  
  CONCLUSIONS
  In BCR patients treated with ADT, the median to CR was 14 years. PSA-DT <6 months, PSA velocity (ng/mL/year) and seminal vesicle involvement were influential variables. From the CR, the median time to death was 3.2 years. Ki-67 marker was an independent influence.
authors.affiliation: Department of Urology, University of Navarra Clinic, Navarra, Spain.
authors.forename: Rubén
authors.initials: R
authors.lastname: Algarra
authors.affiliation: Department of Urology, University of Navarra Clinic, Navarra, Spain.
authors.forename: Mateo
authors.initials: M
authors.lastname: Hevia
authors.affiliation: Department of Urology, University of Navarra Clinic, Navarra, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Tienza
authors.affiliation: Department of Urology, University of Navarra Clinic, Navarra, Spain.
authors.forename: Imanol
authors.initials: I
authors.lastname: Merino
authors.affiliation: Department of Urology, University of Navarra Clinic, Navarra, Spain.
authors.forename: José María
authors.initials: JM
authors.lastname: Velis
authors.affiliation: Department of Urology, University of Navarra Clinic, Navarra, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Zudaire
authors.affiliation: Department of Urology, University of Navarra Clinic, Navarra, Spain.
authors.forename: José Enrique
authors.initials: JE
authors.lastname: Robles
authors.affiliation: Department of Urology, University of Navarra Clinic, Navarra, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Pascual