Key result
Following radical prostatectomy, the risk for biochemical recurrence persisted long-term, with a biochemical recurrence-free survival of 69% at 15 years.
Why the study?
The study evaluated long-term risk for biochemical recurrence and subsequent prognosis in a population-based cohort.
Does the risk for biochemical recurrence and subsequent progression persist long-term after radical prostatectomy in prostate cancer patients?
Cohort (n=6,675)
Yes
Does the risk for biochemical recurrence and subsequent progression persist long-term after radical prostatectomy in prostate cancer patients?
The risk for biochemical recurrence persists up to 15 years after radical prostatectomy, suggesting follow-up should continue as long as treatment would be considered for recurrent disease.
May support extended PSA surveillance when salvage therapy is feasible; extends recurrence timing data in a large observational cohort.
OBJECTIVE: We evaluated long-term risk for biochemical recurrence and subsequent prognosis in a population-based cohort. MATERIAL AND METHODS: We used register-based data to evaluate 6 675 consecutive patients having radical prostatectomy in Västra Götaland county in Sweden during 1995-2014. Patients were followed until death or end of study, 31 December 2014. Data were collected from registers on national, regional and local level and linked by means of the Swedish personal identity number. Biochemical recurrence was defined as PSA ≥0.2 ng/ml; failure as hormonal treatment, metastasis or prostate cancer death. Survival analysis was used to estimate time to biochemical recurrence and time to failure after biochemical recurrence for patients with 0 - 2 years, 2-5 years, 5-10 years and >10 years interval to biochemical recurrence, respectively. RESULTS: A total of 1214 men had biochemical recurrence during follow-up. Biochemical recurrence-free survival was 83% (95% confidence interval [CI] 82-84%), 75% (95% CI 74-77%) and 69% (95% CI 67-71%) at 5, 10 and 15 years, respectively. Cumulative incidence of failure for all patients 15 years after biochemical recurrence was 50% (95% CI 43-55%) in competing risk analysis. The risk of failure after biochemical recurrence was highest among patients having biochemical recurrence within 2 years from surgery. Incomplete data on PSA-history is a limitation. CONCLUSIONS: The risk for biochemical recurrence persists 15 years after surgery. Follow-up should continue as long as treatment would be considered in case of recurrent disease.
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Axén et al. (2022) conducted a cohort in Prostate cancer (n=6,675). Radical prostatectomy was evaluated on Biochemical recurrence-free survival at 15 years (95% CI 67-71). Following radical prostatectomy, the risk for biochemical recurrence persisted long-term, with a biochemical recurrence-free survival of 69% at 15 years.
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