Validating the association of adverse pathology with distant metastasis and prostate cancer mortality 20-years after radical prostatectomy

• DOI: 10.1016/j.urolonc.2021.10.005
• Publication Date: 2021-11-23T06:18:29Z
• Authors: Michael A. Brooks; Lewis Thomas; Cristina Magi-Gal...; Jianbo Li; Michael R. Crager; Ruixiao Lu; Frederick L. Baehner; John Abran; Tamer Aboushwareb; Eric A. Klein
• Keywords: Biochemical recurrence

To assess the association of adverse pathology (AP), defined as high-grade (≥ Gleason Grade Group 3) and/or non-organ confined disease, with long-term oncologic outcomes after radical prostatectomy (RP).Using a stratified cohort sampling design, we evaluated AP risk distant metastasis (DM) and prostate cancer-specific mortality (PCSM) up to 20 years RP in 428 patients treated between 1987 2004. Cox regression cause-specific hazards was used estimate absolute both endpoints, death from other causes competing risk. Additionally, subgroup analysis low intermediate-risk who are potentially eligible for active surveillance (AS), performed.Within sample, 53% men exhibited at time RP, median follow 15.5 (IQR 14.6-16.6 years) thereafter. Adverse highly associated DM PCSM overall (HR 12.30, 95% confidence interval [CI] 5.30-28.55, HR 10.03, CI 3.42-29.47, respectively, P < 0.001). also low/intermediate-risk 10.48, 4.18-26.28, 8.60, 2.40-30.48, 0.001).Adverse is future development PCSM. Accurate prediction may thus be useful individualizing risk-based treatment strategies.