Improving the prediction of biochemical recurrence after radical prostatectomy with the addition of detailed pathology of the positive surgical margin and cribriform growth

• DOI: 10.1016/j.anndiagpath.2021.151842
• Publication Date: 2021-10-25T13:18:07Z
• Authors: Sebastiaan Remmers; Eva Hollemans; Daan Nieboer; Henk B. Luiting; Geert J.L.H. van ...; Jozien Helleman; Monique J. Roobol
• Keywords: Biochemical recurrence; Surgical margin; Cribriform; Interquartile range; breakpoint cluster region; Nomogram; Lymphovascular invasion; Grading (engineering)

The risk on biochemical recurrence (BCR) after radical prostatectomy (RP) is usually estimated using PSA and pathological stage grading including the presence of positive surgical margins (PSM). Objective was to investigate whether cribriform growth in primary tumor, Grade Group (GG) at PSM, length PSM have added value prognostication. We analyzed data 835 patients initially treated with RP between 2000 2017. Cox regression models were developed compare baseline model (PSA, pT-stage, pN-stage, GG RP, PSM) an extended (adding growth, likelihood ratio test. Discrimination assessed internal validation by time-dependent area under receiver operating characteristic curve (AUC) 3- 5-year. A total 224 men experienced BCR. Median follow-up for without BCR 50.4 months (interquartile range, IQR 11.9-95.5). had a significant better fit, χ2(4) = 31.0, p < 0.001 than model. AUC 5-year 0.85 (95% CI 0.81-0.88) compared 0.83 0.79-0.87) Importantly, ≥ 2 associated higher In conclusion, addition variables improved prediction slightly. However, clinical implications this are important.