Defining predictors of early, intermediate, and late biochemical recurrence in men with clinically localized prostate cancer treated with minimally invasive radical prostatectomy.

Authors

null

Silvia Garcia Barreras

Institut Mutualiste Montsouris, University Paris-Descartes, Paris, France

Silvia Garcia Barreras , Igor Nunes-Silva , Rafael Sanchez-Salas , Fernando P. Secin , Victor Srougi , Mohammed Baghdadi , Eric Barret , Francois Rozet , Marc Galiano , Xavier Cathelineau

Organizations

Institut Mutualiste Montsouris, University Paris-Descartes, Paris, France, CEMIC University Hospital and San Lazaro Foundation, Capital Federal, Argentina

Research Funding

Other

Background: Follow up after radical prostatectomy should be tailored to clinical and pathologic characteristics. To determine predictive factors for early, intermediate and late biochemical recurrence (BCR) after minimally invasive radical prostatectomy (MIRP: lap and robot) in patients with localized prostate cancer (PCa). Methods: Prospective clinical, pathologic, and outcome data were collected for 6195 patients with cT1-3N0M0 PCa treated with MIRP at our institution from 2000 to 2016. None of them received neoadjuvant therapy. BCR was defined as PSA level greater than 0.2 ng/ml. Time to BCR was divided in terciles to identify variables associated with early ( < 12 months), intermediate (12-36 months) and late BCR ( > 36 months). Comparisons among groups were performed using ANOVA or Chi square test. Logistic regression models were built to determine risk factors associated with BCR at each time interval. Results: We identified 1148 (19%) patients with BCR. Median time to BCR was 24 months. Statistically significant differences were found between the groups concerning PSA preoperative, D’Amico risk, type of surgery, pT stage, pathological Gleason, positive margins and extracapsular extension. Multivariable logistic regression analysis showed preoperative PSA, positive nodes, positive surgical margins and laparoscopic surgery were associated with early BCR. Laparoscopic surgery was the only risk factor associated with intermediate term BCR. Significant predictors of late BCR included Gleason ≥ 7, ≥ pT3, positive surgical margins, lymph node dissection performance and laparoscopic surgery. Conclusions: Patients with high risk features like Gleason ≥ 7, ≥ pT3 and or positive surgical margins may develop late recurrence and deserve long term follow up. Identify patients with higher PSA and lymph node invasion has an important predictive role due to the risk of BCR within the first year. The association between laparoscopic technique and late BCR deserves further evaluation.

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Abstract Details

Meeting

2017 Genitourinary Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session B: Prostate Cancer and Urothelial Carcinoma

Track

Prostate Cancer,Urothelial Carcinoma,Prostate Cancer

Sub Track

Prostate Cancer - Localized Disease

Citation

J Clin Oncol 35, 2017 (suppl 6S; abstract 113)

DOI

10.1200/JCO.2017.35.6_suppl.113

Abstract #

113

Poster Bd #

B7

Abstract Disclosures

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