Conditional Disease-free Survival After Radical Prostatectomy: Recurrence Risk Evolution Over Time

Area of Science:

• Urology
• Oncology
• Survival Analysis

Background:

• Radical prostatectomy (RP) is a primary treatment for prostate cancer.
• Understanding long-term disease-free survival (DFS) and prognostic factors is crucial.
• Conditional survival (CS) offers dynamic risk assessment post-treatment.

Purpose of the Study:

• To evaluate changes in conditional disease-free survival (DFS) rates after radical prostatectomy (RP).
• To analyze how prognostic factors influence DFS over time post-RP.

Main Methods:

• Kaplan-Meier method for conditional survival (CS) probability estimation.
• Multivariable Cox regression for hazard ratio calculation.
• Analysis of 2813 patients treated with RP and followed postoperatively.

Main Results:

• 5-year DFS rate was 71.2%.
• Conditional 5-year DFS significantly improved with time elapsed post-RP, particularly for patients with adverse pathologic factors (e.g., pT3b-4 disease).
• The impact of Gleason score and pT stage on CS remained stable over time.

Conclusions:

• Time elapsed since RP is a significant factor in disease-free survival (DFS).
• The risk of recurrence diminishes with longer survival post-RP, especially in high-risk groups.
• Conditional survival (CS) provides valuable, updated risk information for managing patients after RP.