Predictors of Biochemical Failure after Radical Perineal Prostatectomy for Localized Prostate Cancer

Hyun, Ji hwan; Chai, Soo Eung; Choi, Han Yong

Abstract

PURPOSE: We analyzed the radical prostatectomy cases retrospectively to stratify the risk of biochemical failure in order to appropriately select patients who potentially may benefit from adjuvant therapy.
MATERIALS AND METHODS
A Cox multiple regression test was used to identify the variables associated with biochemical failure in 82 patients that underwent a radical perineal prostatectomy for prostate cancer, between 1995 and 2001, at the Samsung Medical Center. Numerous clinicopathological variables, including preoperative PSA, clinical stage, prostatectomy Gleason score, perineural invasion, seminal vesicle invasion, margin status, and pathological stage were evaluated. The Kaplan-Meier method was used to calculate the biochemical failure rates(BFR).
RESULTS
Of the 82 patients, a biochemical failure developed in 17(20.7%) after a mean follow-up of 30.5 months. The overall BFR's calculated by the Kaplan-Meier method at 3 and 5 years were 24.9 and 29.3%, respectively. A biochemical failure was associated with the preoperative PSA, perineural invasion, seminal vesicle invasion, margin status and pathological stage(all log rank test p<0.05) in a univariate analysis. However, all the predictors, with the exception of the preoperative PSA, failed to remain significant with the multivariate model.
CONCLUSIONS
The preoperative PSA is a strong independent predictor of biochemical failure in patients that underwent a radical perineal prostatectomy as a definitive local therapy for prostate cancer.