Short-term prognosis of low-risk prostate cancer patients is favorable despite the presence of pathological prognostic factors: a retrospective study
Abstract Background Prostate cancer patients with pathological prognostic factors have a poor prognosis, but it is unclear whether pathological prognostic factors are associated with prognosis limited to low-risk patients with good prognosis according to NCCN guidelines. The present study examined w...
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BMC
2023-10-01
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| Series: | BMC Urology |
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| Online Access: | https://doi.org/10.1186/s12894-023-01345-z |
| _version_ | 1797636661330313216 |
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| author | Remi Semba Katsunori Uchida Yoshihumi Hirokawa Taizo Shiraishi Takehisa Onishi Takeshi Sasaki Takahiro Inoue Masatoshi Watanabe |
| author_facet | Remi Semba Katsunori Uchida Yoshihumi Hirokawa Taizo Shiraishi Takehisa Onishi Takeshi Sasaki Takahiro Inoue Masatoshi Watanabe |
| author_sort | Remi Semba |
| collection | DOAJ |
| description | Abstract Background Prostate cancer patients with pathological prognostic factors have a poor prognosis, but it is unclear whether pathological prognostic factors are associated with prognosis limited to low-risk patients with good prognosis according to NCCN guidelines. The present study examined whether prognosis is influenced by pathological prognostic factors using radical prostatectomy (RP) specimens from low-risk patients. Methods We evaluated diagnostic accuracy by examining biochemical recurrence (BCR)-free survival with respect to clinical and pathological prognostic factors in 419 all-risk patients who underwent RP. Clinical prognostic factors included age, prostate-specific antigen (PSA) levels, PSA density, and risk stratification, while pathological prognostic factors included grade group, lymphovascular space invasion, extraprostatic extension, surgical margins, seminal vesicle invasion, intraductal carcinoma of the prostate (IDCP), and pT. In a subsequent analysis restricted to 104 low-risk patients, survival curves were estimated for pathological prognostic factors using the Kaplan–Meier method and compared using log-rank and generalized Wilcoxon tests. Results In the overall risk analysis, the presence of pathological prognostic factors significantly shortened BCR-free survival (p < 0.05). Univariable analysis revealed that PSA density, risk categories, and pathological prognostic factors were significantly associated with BCR-free survival, although age and PSA were not. In multivariable analysis, age, risk categories, grade group, IDCP, and pT significantly predicted BCR-free survival (p < 0.05). Conversely, no statistically significant differences were found for any pathological prognostic factors in low-risk patients. Conclusions In low-risk patients, pathological prognostic factors did not affect BCR-free survival, which suggests that additional treatment may be unnecessary even if pathological prognostic factors are observed in low-risk patients with RP. |
| first_indexed | 2024-03-11T12:37:14Z |
| format | Article |
| id | doaj.art-0d754f1f87574bdb85a4ed03df165066 |
| institution | Directory Open Access Journal |
| issn | 1471-2490 |
| language | English |
| last_indexed | 2024-03-11T12:37:14Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Urology |
| spelling | doaj.art-0d754f1f87574bdb85a4ed03df1650662023-11-05T12:30:39ZengBMCBMC Urology1471-24902023-10-012311910.1186/s12894-023-01345-zShort-term prognosis of low-risk prostate cancer patients is favorable despite the presence of pathological prognostic factors: a retrospective studyRemi Semba0Katsunori Uchida1Yoshihumi Hirokawa2Taizo Shiraishi3Takehisa Onishi4Takeshi Sasaki5Takahiro Inoue6Masatoshi Watanabe7Department of Oncologic Pathology, Mie University Graduate School of MedicineDepartment of Oncologic Pathology, Mie University Graduate School of MedicineDepartment of Oncologic Pathology, Mie University Graduate School of MedicineDepartment of Pathology, Kuwana City Medical CenterDepartment of Urology, Japanese Red Cross Ise HospitalDepartment of Nephro-Urologic Surgery and Andrology, Mie University HospitalDepartment of Nephro-Urologic Surgery and Andrology, Mie University HospitalDepartment of Oncologic Pathology, Mie University Graduate School of MedicineAbstract Background Prostate cancer patients with pathological prognostic factors have a poor prognosis, but it is unclear whether pathological prognostic factors are associated with prognosis limited to low-risk patients with good prognosis according to NCCN guidelines. The present study examined whether prognosis is influenced by pathological prognostic factors using radical prostatectomy (RP) specimens from low-risk patients. Methods We evaluated diagnostic accuracy by examining biochemical recurrence (BCR)-free survival with respect to clinical and pathological prognostic factors in 419 all-risk patients who underwent RP. Clinical prognostic factors included age, prostate-specific antigen (PSA) levels, PSA density, and risk stratification, while pathological prognostic factors included grade group, lymphovascular space invasion, extraprostatic extension, surgical margins, seminal vesicle invasion, intraductal carcinoma of the prostate (IDCP), and pT. In a subsequent analysis restricted to 104 low-risk patients, survival curves were estimated for pathological prognostic factors using the Kaplan–Meier method and compared using log-rank and generalized Wilcoxon tests. Results In the overall risk analysis, the presence of pathological prognostic factors significantly shortened BCR-free survival (p < 0.05). Univariable analysis revealed that PSA density, risk categories, and pathological prognostic factors were significantly associated with BCR-free survival, although age and PSA were not. In multivariable analysis, age, risk categories, grade group, IDCP, and pT significantly predicted BCR-free survival (p < 0.05). Conversely, no statistically significant differences were found for any pathological prognostic factors in low-risk patients. Conclusions In low-risk patients, pathological prognostic factors did not affect BCR-free survival, which suggests that additional treatment may be unnecessary even if pathological prognostic factors are observed in low-risk patients with RP.https://doi.org/10.1186/s12894-023-01345-zBiochemical recurrence-free survivalProstate cancer |
| spellingShingle | Remi Semba Katsunori Uchida Yoshihumi Hirokawa Taizo Shiraishi Takehisa Onishi Takeshi Sasaki Takahiro Inoue Masatoshi Watanabe Short-term prognosis of low-risk prostate cancer patients is favorable despite the presence of pathological prognostic factors: a retrospective study BMC Urology Biochemical recurrence-free survival Prostate cancer |
| title | Short-term prognosis of low-risk prostate cancer patients is favorable despite the presence of pathological prognostic factors: a retrospective study |
| title_full | Short-term prognosis of low-risk prostate cancer patients is favorable despite the presence of pathological prognostic factors: a retrospective study |
| title_fullStr | Short-term prognosis of low-risk prostate cancer patients is favorable despite the presence of pathological prognostic factors: a retrospective study |
| title_full_unstemmed | Short-term prognosis of low-risk prostate cancer patients is favorable despite the presence of pathological prognostic factors: a retrospective study |
| title_short | Short-term prognosis of low-risk prostate cancer patients is favorable despite the presence of pathological prognostic factors: a retrospective study |
| title_sort | short term prognosis of low risk prostate cancer patients is favorable despite the presence of pathological prognostic factors a retrospective study |
| topic | Biochemical recurrence-free survival Prostate cancer |
| url | https://doi.org/10.1186/s12894-023-01345-z |
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