Open Access

Prostate‑specific antigen density and preoperative MRI findings as predictors of biochemical recurrence in high‑risk and very high‑risk prostate cancer

  • Authors:
    • Cheng-Kuang Yang
    • Chi-Rei Yang
    • Yen-Chuan Ou
    • Chen-Li Cheng
    • Hao-Chung Ho
    • Kun-Yuan Chiu
    • Shian-Shiang Wang
    • Jian-Ri Li
    • Chuan-Shu Chen
    • Chi-Feng Hung
    • Cheng-Che Chen
    • Shu-Chi Wang
    • Chia-Yen Lin
    • Sheng-Chun Hung
  • View Affiliations

  • Published online on: May 18, 2023     https://doi.org/10.3892/ol.2023.13870
  • Article Number: 284
  • Copyright: © Yang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Patients with high‑risk prostate cancer after prostatectomy have a particularly high chance of being diagnosed with biochemical recurrence (BCR). Patients with BCR have a greater risk of disease progression and mortality. The present retrospective observational study aimed to clarify the risk factors for the BCR of prostate cancer after radical prostatectomy in patients with high‑risk and very high‑risk prostate cancer. Patients diagnosed with prostate cancer who received radical prostatectomy in a single center from January 2009 to June 2020 were included in the study. Data from medical records were reviewed and the patients were followed up for ≥6 years. The primary outcome was BCR within 1 year after surgery. A total of 307 patients were included, with 187 in the high‑risk group and 120 in the very high‑risk group as classified by the National Comprehensive Cancer Network (NCCN) guidelines. Patients in the very high‑risk group had a lower BCR‑free survival rate compared with those in the high‑risk group, with a high risk of BCR even if their PSA levels were initially undetectable after prostatectomy, and a high risk of postoperatively detectable PSA. In patients with undetectable PSA after prostatectomy, BCR was associated with the initial PSA density, imaging stage (T3aN0M0 and T3bN0M0), and pathologic stage (any N1). Postoperatively detectable PSA was associated with pathologic stage (T3bN0M0 and any N1) In conclusion, preoperative MRI imaging stage and PSA density are predictors for short‑term BCR after prostatectomy. NCCN‑defined high‑risk patients with a high initial PSA density, imaging stage (T3aN0M0 and T3bN0M0), and pathologic stage (any N1) had a higher risk of BCR when compared with other patients with undetectable PSA, while those with pathologic stage (T3bN0M0 or any N1) displayed a higher risk of postoperatively detectable PSA. These findings may help urologists to identify patients for whom active therapeutic protocols are necessary.
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July-2023
Volume 26 Issue 1

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Spandidos Publications style
Yang C, Yang C, Ou Y, Cheng C, Ho H, Chiu K, Wang S, Li J, Chen C, Hung C, Hung C, et al: Prostate‑specific antigen density and preoperative MRI findings as predictors of biochemical recurrence in high‑risk and very high‑risk prostate cancer. Oncol Lett 26: 284, 2023
APA
Yang, C., Yang, C., Ou, Y., Cheng, C., Ho, H., Chiu, K. ... Hung, S. (2023). Prostate‑specific antigen density and preoperative MRI findings as predictors of biochemical recurrence in high‑risk and very high‑risk prostate cancer. Oncology Letters, 26, 284. https://doi.org/10.3892/ol.2023.13870
MLA
Yang, C., Yang, C., Ou, Y., Cheng, C., Ho, H., Chiu, K., Wang, S., Li, J., Chen, C., Hung, C., Chen, C., Wang, S., Lin, C., Hung, S."Prostate‑specific antigen density and preoperative MRI findings as predictors of biochemical recurrence in high‑risk and very high‑risk prostate cancer". Oncology Letters 26.1 (2023): 284.
Chicago
Yang, C., Yang, C., Ou, Y., Cheng, C., Ho, H., Chiu, K., Wang, S., Li, J., Chen, C., Hung, C., Chen, C., Wang, S., Lin, C., Hung, S."Prostate‑specific antigen density and preoperative MRI findings as predictors of biochemical recurrence in high‑risk and very high‑risk prostate cancer". Oncology Letters 26, no. 1 (2023): 284. https://doi.org/10.3892/ol.2023.13870