@article{moore2015predictors,
  title = {Predictors of Recurrence in Patients with High-Risk Pathology after Prostatectomy},
  author = {David C. Moore and Matthew J. Resnick and Daniel A. Barocas and Rodney Davis and Michael S. Cookson and Peter Clark and S. Duke Herrell and Chirag S. Kulahalli and Giovanna Giannico and Joseph A. Smith and Chaochen You and Sam S. Chang},
  year = 2015,
  url = {https://ibimapublishing.com/articles/UROL/2015/356402/},
  journal = {International Journal of Research in Urology},
  volume = 2015 (2015),
  pages = 12,
  doi = 10.5171/2015.673284,
  abstract = {Background: To determine the pattern of recurrence in patients with high-risk pathology at radical prostatectomy and to identify disease characteristics associated with clinical and biochemical recurrence (BCR).  Methods: We identified 893 patients who underwent radical prostatectomy between January 2000 and June 2009 with pathologic T3N0 disease or T2N0 disease and positive surgical margins who did not receive adjuvant radiotherapy. We evaluated univariate relationships between individual covariates and risk of BCR. We then fit a multivariable Cox regression model to evaluate the independent predictive power of relevant covariates, and utilized the multivariate model to demonstrate the risk of BCR. Results: Of the 893 patients, 519 (58.1%) had pT3 disease while 374 (41.9%) had pT2 disease with positive surgical margins. Within the cohort, 26.0% sustained BCR during a median follow up of 55.0 months (IQR 39.5-78.8). Pre-operative PSA, Gleason score, extraprostatic extension and seminal vesicle invasion were independently associated with time to recurrence, while surgical margin status was not.  Five-year BCR-free survival was 79% for pT2 margin+, 67% for pT3a and 54% for pT3b; 88% for Gleason 5-6, 69% for Gleason 7, and 51% for Gleason 8-10. Conclusions: BCR is common in patients with high-risk pathologic features, but many such patients exhibit long-term disease-free survival. By using common clinicopathologic features, it is possible to risk stratify this heterogeneous group of patients to facilitate early radiotherapy for those at high-risk of recurrence while minimizing morbidity in those who stand to gain little from additional treatment.},
  keywords = {prostate cancer, recurrence, prostate specific antigen, radiation therapy, risk factors},
  note = Article ID: 356402
}