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KMID : 1812320230400040412
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Journal of Yeungnam Medical Science
2023 Volume.40 No. 4 p.412 ~ p.418
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Risk factors for prostate-specific antigen persistence in pT3aN0 prostate cancer after robot-assisted laparoscopic radical prostatectomy: a retrospective study
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Kim Jun-Seop
Chung Jae-Hoon
Song Wan
Kang Min-Yong
Sung Hyun-Hwan
Jeon Hwang-Gyun
Jeong Byong-Change
Seo Seong-Il
Bashir Bello
Jeon Seong-Soo
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Abstract
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Background The aim of this study was to evaluate the risk factors for prostate-specific antigen (PSA) persistence in pathological stage T3aN0 prostate cancer (PCa) after robot-assisted laparoscopic radical prostatectomy (RALP).
Methods A retrospective study was performed on 326 patients with pT3aN0 PCa who underwent RALP between March 2020 and February 2022. PSA persistence was defined as nadir PSA of >0.1 ng/mL after RALP, and the risk factors for PSA persistence were evaluated using logistic regression analysis.
Results Among 326 patients, 61 (18.71%) had PSA persistence and 265 (81.29%) had PSA of <0.1 ng/mL after RALP (successful radical prostatectomy [RP] group). In the PSA persistence group, 51 patients (83.61%) received adjuvant treatment. Biochemical recurrence occurred in 27 patients (10.19%) in the successful RP group during the mean follow-up period of 15.22 months. Multivariate analysis showed that the risk factors for PSA persistence were large prostate volume (hazard ratio [HR], 1.017; 95% confidence interval [CI], 1.002?1.036; p=0.046), lymphovascular invasion (LVI) (HR, 2.605; 95% CI, 1.022?6.643; p=0.045), and surgical margin involvement (HR, 2.220; 95% CI, 1.110?4.438; p=0.024).
Conclusion Adjuvant treatment may be needed for improved prognosis in patients with pT3aN0 PCa after RALP with a large prostate size, LVI, or surgical margin involvement.
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KEYWORD
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Prostatectomy, Prostatic neoplasms, Risk factors
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