Predictive factors associated with biochemical recurrence following radical prostatectomy for pathological T2 prostate cancer with negative surgical margins

Objective: The aim of this study was to determine factors associated with the development of biochemical recurrence (BCR) following radical prostatectomy in patients with pathological T2 prostate cancer and negative surgical margins.Materials and methods: This retrospective multicentre cohort study included 1252 consecutive patients with pT2 pN0/Nx and negative surgical margins on radical prostatectomy and without any adjuvant treatment, performed in three Belgian centres. BCR-free survival curves were estimated using the Kaplan-Meier method. Univariate and multivariate analyses using the Cox proportional hazards model were performed to determine clinical and pathological predictive factors of BCR in this group of patients.Results: In total, 910 patients were included. BCR occurred in 107 patients (11.8%) at a median follow-up of 108 months. Overall 5 and 10 year BCR-free survival rates were 90% and 87%, respectively. On the multivariate analyses, serum prostate-specific antigen (PSA) level (p =.001) and surgical Gleason score of 7 or above (p =.001) were significantly associated with BCR in men with pathological T2 prostate cancer with negative surgical margins. Perineural invasion and capsular infiltration were not risk factors for recurrence.Conclusions: This study identified unfavourable risk factors in patients with pathological T2 and negative surgical margins following radical prostatectomy. The results suggest that patients with a surgical Gleason score of 7 or higher, unknown lymph-node status and high PSA values are at increased risk of recurrence.