In patients with prostate cancer undergoing open radical prostatectomy, early identification of those at risk for biochemical failure (persistence or recurrence) is crucial to guide timely treatment. The aim of this study was to identify clinical, biochemical, and histopathological factors associated with biochemical failure during a 2‐year postoperative follow‐up and to assess their predictive value. A retrospective, cross‐sectional study was conducted on patients who underwent open radical prostatectomy at a tertiary care hospital between 2008 and 2021 to evaluate patient clinical, biochemical, and histopathological characteristics. Descriptive statistics were calculated, and comparisons (Mann—Whitney U tests) or associations (chi‐square tests) among the characteristics were performed and compared between patients grouped according to the absence or presence of biochemical failure. Receiver operating characteristic curves were used to evaluate predictive performance. α = 0.05 was used in all tests. A total of 163 patients were considered, 117 of which (age range, 50–77 years) met the inclusion criteria. Biochemical failure occurred in 48.70% of patients (24.80% persistence and 23.90% recurrence). A total of 29.06% of patients presented with extracapsular extension, which was significantly associated with biochemical failure ( p = 0.027). Prostate‐specific antigen density (PSAD) shows predictive value (AUC = 0.617, p = 0.029), with a cutoff point of PSAD ≥ 0.25, yielding 54.40% sensitivity and 65.00% specificity. The 2‐year odds ratio for biochemical failure was 2.06 ( p = 0.05). Overall, 48.70% of the patients experienced biochemical failure during the first 2 years of follow‐up. Extracapsular extension was associated with higher risk of biochemical failure. Our findings suggest that PSAD ≥ 0.25 is a predictive factor for the occurrence of biochemical failure. It is important to conduct multicenter studies with larger sample sizes to validate these findings and strengthen prediction and follow‐up strategies.
Rodea-Montero et al. (Thu,) studied this question.