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Abstract：
Background: Biochemical recurrence (BCR) represents the rise of prostate-specific antigen (PSA) levels after treatment with curative radical prostatectomy (RP) or radiation for prostate cancer. The objective of the current study was to test for the association between patient characteristics, namely age, body mass index (BMI), as well as prostate volume at surgery, and BCR after RP. Material and Methods: Within a tertiary care database, patients with prostate cancer treated with RP between January 2014 and June 2023 were included. Kaplan-Meier survival analyses and Cox regression models addressed BCR after RP according to patient characteristics. Results: Of 821 patients, the median age was 66 years (interquartile range [IQR] 61-71 years), BMI was 26.2 kg/m2 (IQR 24.3-28.8 kg/m2), and prostate volume was 40 cm3 (IQR 30-55 cm3). Median follow-up was 20 months. In survival analyses, the three-year BCR-free survival rates were 81 vs. 84 vs. 81% in patients aged ≤60 vs. 61-69 vs. 70 years (p = 0.1). In patients with BMI < 25.0 vs. 25.0-29.9 vs. ≥30.0 kg/m2, the three-year BCR-free survival rates were 84 vs. 81 vs. 84% (p = 0.7). In patients with prostate volume ≤40 vs. >40 cm3, the three-year BCR-free survival rates were 85 vs. 80% (p = 0.004). In multivariable Cox regression models accounting for patient and pathologic tumor characteristics and adjuvant radiation therapy, a higher prostate volume independently predicted BCR as continuous (hazard ratio 1.012, 95% confidence interval 1.005-1.019; p < 0.001), as well as categorized the variable based on the median (hazard ratio 1.66, 95% confidence interval 1.17-2.36; p = 0.005). Conversely, neither age nor BMI were significantly associated with BCR after RP. Conclusions: The higher prostate volume independently predicted BCR after RP, but not age or BMI at surgery. Consequently, patients with an elevated prostate volume should be considered for closer postoperative follow-up.
摘要：
背景：生化复发（BCR）代表前列腺癌根治性前列腺切除术（RP）或放疗治疗后前列腺特异性抗原（PSA）水平的升高。当前研究的目的是测试患者特征之间的关联，即年龄,体重指数（BMI），以及手术时的前列腺体积，和RP后的BCR。材料和方法：在三级护理数据库中，纳入2014年1月至2023年6月期间接受RP治疗的前列腺癌患者.Kaplan-Meier生存分析和Cox回归模型根据患者特征解决RP后BCR。结果：在821例患者中，中位年龄为66岁（四分位距[IQR]61-71岁），BMI为26.2kg/m2（IQR24.3-28.8kg/m2），前列腺体积为40cm3（IQR30-55cm3）。中位随访时间为20个月。在生存分析中，三年无BCR生存率为81vs.84vs.81%年龄≤60岁的患者与61-69vs.70年（p=0.1）。BMI<25.0的患者与25.0-29.9vs.≥30.0kg/m2，三年无BCR生存率为84vs.81vs.84%(p=0.7)。前列腺体积≤40的患者与>40cm3，三年无BCR生存率为85vs.80%(p=0.004)。在考虑患者和病理肿瘤特征和辅助放射治疗的多变量Cox回归模型中，较高的前列腺体积独立预测BCR为连续（风险比1.012，95％置信区间1.005-1.019；p<0.001），并根据中位数对变量进行分类（风险比1.66，95％置信区间1.17-2.36；p=0.005）。相反，年龄和BMI均与RP后BCR无显著相关性。结论：较高的前列腺体积独立预测RP后的BCR，但不是手术时的年龄或BMI。因此,前列腺体积增大的患者应考虑进行更密切的术后随访.
