title: Predictive factors of late biochemical recurrence after radical prostatectomy.
abstract: OBJECTIVE
  To assess the characteristics of biochemical recurrence in the late period (>5 years after radical prostatectomy) and the differences in the predictors of biochemical recurrence in different periods, we conducted a multicenter retrospective study.
  
  
  METHODS
  We reviewed 478 men who underwent radical prostatectomy for clinically localized prostate cancer. All of the patients were followed up for at least 5 years. The cohort was then divided into three groups; no recurrence group, recurrence <5 years after surgery group and recurrence ≥5 years after surgery group. The background characteristics of each group were compared using the χ2 test. A Cox multivariate regression analysis was performed to determine the predictors of biochemical recurrence in each period.
  
  
  RESULTS
  Biochemical recurrence occurred in 135 men. In 113 (84%) of the patients, biochemical recurrence occurred at <5 years after surgery; in 22 (16%), it occurred at ≥5 years after surgery. The proportion of men with a low preoperative prostate-specific antigen level was significantly larger in the latter group (P = 0.0023). A preoperative prostate-specific antigen level and a positive surgical margin were significant predictors of biochemical recurrence at <5 years after surgery (hazard ratio: 1.03 and 3.20). A positive surgical margin was also a significant predictor of biochemical recurrence at ≥5 years after surgery (hazard ratio: 3.03); however, a high preoperative prostate-specific antigen level was not.
  
  
  CONCLUSIONS
  Biochemical recurrence occurred at ≥5 years after surgery in 16% of the patients. A positive surgical margin predicted biochemical recurrence in both the early and late periods.
authors.affiliation: Department of Urology, National Hospital Organization Kyushu Cancer Center, Fukuoka.
authors.forename: Takahito
authors.initials: T
authors.lastname: Negishi
authors.affiliation: Department of Urology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki.
authors.forename: Kentarou
authors.initials: K
authors.lastname: Kuroiwa
authors.affiliation: Department of Urology, Miyazaki Prefectural Miyazaki Hospital, Miyazaki.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Hori
authors.affiliation: Department of Urology, Oita Prefectural Hospital, Oita.
authors.forename: Toshihisa
authors.initials: T
authors.lastname: Tomoda
authors.affiliation: Department of Urology, Saga-Ken Medical Center Koseikan, Saga, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Uchino
authors.affiliation: Department of Urology, Saga-Ken Medical Center Koseikan, Saga, Japan.
authors.forename: Noriaki
authors.initials: N
authors.lastname: Tokuda
authors.affiliation: Department of Urology, National Hospital Organization Kyushu Cancer Center, Fukuoka.
authors.forename: Nobuki
authors.initials: N
authors.lastname: Furubayashi
authors.affiliation: Department of Urology, National Hospital Organization Kyushu Cancer Center, Fukuoka.
authors.forename: Kei
authors.initials: K
authors.lastname: Nagase
authors.affiliation: Department of Urology, National Hospital Organization Kyushu Cancer Center, Fukuoka.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Iwai
authors.affiliation: Department of Urology, National Hospital Organization Kyushu Cancer Center, Fukuoka.
authors.forename: Motonobu
authors.initials: M
authors.lastname: Nakamura
mesh_terms: D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D017430:Prostate-Specific Antigen / Q000378:metabolism*; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies
chemical_list: D017430:Prostate-Specific Antigen
keywords: biochemical recurrence; positive surgical margin; predictive factor; prostate cancer; radical prostatectomy