Biochemical Recurrence Following Radical Prostatectomy in High-Risk Prostate Cancer Patients

Abstract

Aim: Radical prostatectomy (RP) with extended pelvic lymphadenectomy (ePLND) is one of the treatment options for prostate cancer (PC). The aim of this study was to evaluate the impact of RP with ePLND on biochemical recurrence in „high-risk” PC patients. Patients and methods: This retrospective study included patients who initially presented with high-risk PC (Gleason score (GS) ≥ 8 and/or prostate-specific antigen (PSA) level > 20 ng/ml) and had at least 5 years of follow-up. A PSA value higher than 0,20 ng/ml was considered as biochemical recurrence. The hospital database was reviewed to identify patients with high-risk PC who underwent RP/ePLND between January 1, 2013 and December 31, 2017. After patient stratification, 69 patients who initially presented with high-risk prostate cancer (PC) classified as cN0 and cM0 remained. Results: During follow-up biochemical recurrence occurred in 47 patients (68.12%) while PSA remained below 0.20 ng/ml in 22 (31.88%) patients. Preoperative and postoperative PSA values were compared between the two groups, as well as pathohistological findings after prostate biopsy and surgery. A statistically significant difference was observed in postoperative PSA values, Gleason score (GS), and pathological T stage. Conclusion: Surgical treatment alone can lead to successful outcomes of high-risk PC in patients with pathological staging of pT3a or lower and in patients with GS 8 (3+5) or lower.