Prostate cancer: can we predict recurrence?

This study examined the biochemical recurrence (BCR) of prostate cancer after minimally invasive prostate surgery. This study concluded the risk of BCR of prostate cancer decreases as the number of years after surgery without the disease increases. 

One treatment option for patients with prostate cancer is surgical removal of the prostate (radical prostatectomy). Different surgical techniques can be used for this. These include minimally-invasive prostatectomy (MIP) methods such as laparoscopic surgery and robot-assisted surgery. Laparoscopic surgery involves making very small cuts in the abdomen. Robot-assisted surgery uses robotic assistance to remove the prostate.

Prostate cancer is graded based on how aggressive the cancer is. This is called the Gleason score. The higher the Gleason score, the more likely the cancer can grow and spread. Patients are often followed up after surgery to check for biochemical recurrence (BCR) of cancer. This is when there is an increase in prostate-specific antigen (PSA; a protein elevated in the blood during prostate cancer). It is not known if the risk of the disease returning over time can be predicted after MIP.

6195 patients who had a MIP were included in this study. 3576 men had laparoscopic surgery. 2619 men had robotic surgery. The patients were followed up for an average of 8.49 years.

19% of patients had BCR of prostate cancer. 5.94% of men developed BCR after 3 years. BCR was more likely to occur in patients with certain types of disease feature. These included a higher PSA level before surgery or positive surgical margins (these indicate that some cancer cells have been left behind at the tumor site after surgery). Patients who had laparoscopic surgery, or had a high Gleason score and patients with extracapsular extension (the cancer has spread into and beyond the outer lining of the prostate gland) also had a higher risk of BCR. 

This study concluded that the risk of BCR of prostate cancer decreases, as the number of years without the disease increases. The authours also suggested a number of factors that influence the risk of BCR.

This study was based on medical records. Data collected this way may not be complete. This might influence the results.