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Updated: Apr 1, 2026
Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
Prediction of biochemical recurrence after radical prostatectomy. New tool for selecting candidates for adjuvant
F Herranz-Amo1, R Molina-Escudero1, G Ogaya-Pinies1
1Servicio de Urología, Hospital General Universitario Gregorio Marañón, Madrid, España.
Objective:
To design a risk summation to select patients for adjuvant radiation therapy after prostatectomy.
Materials And Method:
A retrospective study was conducted on 629 patients with localised prostate cancer (pN0-pNx) who were treated with prostatectomy and with a prostate-specific antigen (PSA) value <0.2ng/mL at 2-3 months. Biochemical recurrence was defined as a PSA >0.4ng/mL. A multivariate Cox regression analysis was performed. A score (0-2) was assigned according to the hazard ratio of the significant variables. The score summation defined the risk summation.
Results:
A total of 19.7% of the patients were pT3, 24.2% had a Gleason score ≥ 8, and 26.3% had positive surgical margins. The median follow-up was 82 months. Some 26.6% of the patients experienced biochemical recurrence. The identified prognostic variables independent of biochemical recurrence were a Gleason score =7 (4+3) (HR, 2.01; P=.008), a Gleason score ≥ 8 (HR, 3.07; P <.001), a pT3b stage (HR, 1.93; p=.008) and a positive surgical margin (HR, 2.20; P<.001). We assigned 0 points to patients without risk prognosis variables; 1 point to patients with Gleason scores =7 (4+3), pT3b or positive surgical margins; and 2 points to patients with Gleason scores ≥ 8. The patients with a risk summation ≤ 2 had >50% survival free of biochemical recurrence at 5 and 8 years. In contrast, the patients with a risk summation ≥ 3 had <44% survival free of biochemical recurrence.
Conclusion:
The patients with a risk summation ≤ 2 did not benefit from adjuvant radiation therapy, while the patients with a risk summation ≥ 3 might benefit from adjuvant radiation therapy.
