Biochemical recurrence, salvage treatment, and long-term oncological outcomes after radical prostatectomy for International Society of Urological Pathology grade group 2 prostate cancer
Lucas Diéguez-Álvarez, Sara Gil-Carballal, Ana Castelló-Porcar, José María Martínez-JabaloyasABSTRACT
Introduction:
International Society of Urological Pathology (ISUP) grade group (GG) 2 is the most common grade at radical prostatectomy (RP), yet its long-term natural history is poorly defined. We evaluated the predictors of biochemical recurrence (BCR) and the relationship between BCR, salvage treatment, and oncological outcomes.
Methods:
We analyzed 224 consecutive patients with confirmed GG2 prostate cancer after RP between 1999 and 2015. BCR was defined as two consecutive prostate-specific antigen ≥0.2 ng/mL. Kaplan–Meier and competing-risk analyses were performed, and predictors of BCR were assessed using multivariable Cox regression analysis.
Results:
Median follow-up was 209 months. BCR occurred in 91 patients (40.6%) after a median of 47 months. Ten-year BCR-free survival was 62.0%, 72.5% with negative surgical margins, and 51.9% with positive margins (
Conclusions:
In our cohort, PSM was the main predictor of BCR, whereas metastatic progression and prostate cancer-specific death after BCR were uncommon. Favorable outcomes were observed among recurrent patients managed without salvage treatment, although nonrandom treatment allocation and the limited number of progression events preclude causal inference.