title: Predictive factors associated with biochemical recurrence following radical prostatectomy for pathological T2 prostate cancer with negative surgical margins.
abstract: OBJECTIVE
  The aim of this study was to determine factors associated with the development of biochemical recurrence (BCR) following radical prostatectomy in patients with pathological T2 prostate cancer and negative surgical margins.
  
  
  METHODS
  This retrospective multicentre cohort study included 1252 consecutive patients with pT2 pN0/Nx and negative surgical margins on radical prostatectomy and without any adjuvant treatment, performed in three Belgian centres. BCR-free survival curves were estimated using the Kaplan-Meier method. Univariate and multivariate analyses using the Cox proportional hazards model were performed to determine clinical and pathological predictive factors of BCR in this group of patients.
  
  
  RESULTS
  In total, 910 patients were included. BCR occurred in 107 patients (11.8%) at a median follow-up of 108 months. Overall 5 and 10 year BCR-free survival rates were 90% and 87%, respectively. On the multivariate analyses, serum prostate-specific antigen (PSA) level (p = .001) and surgical Gleason score of 7 or above (p = .001) were significantly associated with BCR in men with pathological T2 prostate cancer with negative surgical margins. Perineural invasion and capsular infiltration were not risk factors for recurrence.
  
  
  CONCLUSIONS
  This study identified unfavourable risk factors in patients with pathological T2 and negative surgical margins following radical prostatectomy. The results suggest that patients with a surgical Gleason score of 7 or higher, unknown lymph-node status and high PSA values are at increased risk of recurrence.
authors.affiliation: a Urology Department , Jules Bordet Institute, Université libre de Bruxelles , Brussels , Belgium.
authors.forename: Fouad
authors.initials: F
authors.lastname: Aoun
authors.affiliation: b Urology Department , University Clinics of Brussels, Erasme Hospital, Université libre de Bruxelles , Brussels , Belgium.
authors.forename: Simone
authors.initials: S
authors.lastname: Albisinni
authors.affiliation: b Urology Department , University Clinics of Brussels, Erasme Hospital, Université libre de Bruxelles , Brussels , Belgium.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Henriet
authors.affiliation: c Urology Department , Institut de Recherche clinique (IREC), Cliniques universitaires St Luc, Université catholique de Louvain , Brussels , Belgium.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Tombal
authors.affiliation: a Urology Department , Jules Bordet Institute, Université libre de Bruxelles , Brussels , Belgium.
authors.forename: Roland
authors.initials: R
authors.lastname: Van Velthoven
authors.affiliation: b Urology Department , University Clinics of Brussels, Erasme Hospital, Université libre de Bruxelles , Brussels , Belgium.
authors.forename: Thierry
authors.initials: T
authors.lastname: Roumeguère
mesh_terms: D000368:Aged; D001530:Belgium / Q000453:epidemiology; D015331:Cohort Studies; D018572:Disease-Free Survival; D006801:Humans; D007610:Kallikreins / Q000097:blood*; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D000072662:Margins of Excision; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000453:epidemiology*; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen
keywords: Biochemical recurrence; Gleason score; PSA; negative surgical margin; radical prostatectomy