Login to Access Video or Poster Abstract: MP64-14
Sources of Funding: None

Introduction

Since high-risk prostate cancer is an extremely heterogeneous disease, it is necessary to further stratify this group of patients. The aim of the present study was to substratify surgically treated patients with high-risk prostate cancer according to combination of accepted risk factors. _x000D_

Methods

We identified 239 consecutive patients with NCCN high-risk prostate cancer treated with radical prostatectomy and pelvic lymph node dissection between March 2000 and December 2015 at Wakayama Medical University Hospital. Probabilities of specimen-confined disease (SCD; ?pT3aN0 and RM0) and biochemical recurrence (BCR) were examined with preoperative risk factors (PSA cT stage, biopsy Gleason score [GS]) using multivariable logistic regression and Cox proportional hazard models, respectively. Patients were then classified according to the combination of preoperative risk factors (PSA > 20ng/mL, cT3a, biopsy GS ?8) and probability of SCD and BCR-free survival were compared among groups.

Results

SCD was observed in 139 patients (58.2%). Five-year BCR-free survival rate was 61.7%. Multivariable analyses identified PSA as the only independent predictor of SCD and BCR after adjustment for age and type of surgery (Table). Based on the BCR-free survival rates for seven subgroups according to the combination of three preoperative risk factors, simple model with three subgroups were constructed, i.e., group 1: risk factor(s) other than PSA > 20ngmL; group 2: PSA > 20ng/mL only; group 3: PSA ? 20ng/mL and other risk factor(s). BCR-free survival rates were significantly different among three groups (p < 0.01, Figure). In addition, probabilities of SCD were also significantly different among groups (64.2% vs. 51.1% vs. 34.5%, p<0.01).

Conclusions

This study identified PSA as the most important preoperative risk factor in patients with high-risk prostate cancer and generated simple prognostic model according to PSA-based combination of three risk factors.

Funding

None