Prostate cancer laterality does not predict prostate-specific antigen recurrence after radical prostatectomy.

Area of Science:

• Urology
• Oncology
• Pathology

Background:

• Radical prostatectomy (RP) is a primary treatment for localized prostate cancer.
• Understanding factors predicting post-operative prostate-specific antigen (PSA) recurrence is crucial for patient management.
• The role of tumor laterality (unilateral vs. bilateral) in predicting PSA recurrence after RP remains unclear.

Purpose of the Study:

• To compare the biologic behavior of unilateral versus bilateral prostate cancers.
• To determine if tumor laterality influences PSA recurrence rates following radical prostatectomy.

Main Methods:

• Retrospective analysis of 1184 men undergoing RP for clinically localized prostate cancer (2002-2006).
• Detailed pathologic assessment focusing on tumor laterality and percentage of involvement.
• Statistical analysis using univariate and multivariate methods, including Cox regression.

Main Results:

• 19.2% of patients had completely unilateral prostate cancer.
• Overall PSA recurrence rate was 13.9% at a mean follow-up of 2.7 years.
• No significant difference in PSA recurrence rates between unilateral (11.5%) and bilateral (14.4%) disease (P=0.25).
• Diagnostic PSA level, prostate weight, and pathologic Gleason score were significant predictors of PSA recurrence in unilateral tumors.

Conclusions:

• Tumor laterality (unilateral vs. bilateral) does not predict PSA recurrence after radical prostatectomy.
• Baseline PSA level and pathologic Gleason score are strong independent predictors of PSA recurrence.
• These findings emphasize the importance of established prognostic factors over tumor distribution.