Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 May 27:17:185-194.
doi: 10.2147/RRU.S500506. eCollection 2025.

The Prognostic Value of Perioperative Factors on Biochemical Recurrence in Patients Undergoing Radical Prostatectomy

Nikolaos Pyrgidis #  1 , Philipp Weinhold #  1 , Gerald Bastian Schulz  1 , Michael Chaloupka  1 , Elena Berg  1 , Thilo Westhofen  1 , Severin Rodler  1 , Patrick Keller  1 , Friedrich Jokisch  1 , Christian G Stief  1 , Julian Marcon  1 , Robert Bischoff  1
Affiliations

The Prognostic Value of Perioperative Factors on Biochemical Recurrence in Patients Undergoing Radical Prostatectomy

Nikolaos Pyrgidis et al. Res Rep Urol. .

Abstract

Introduction: We aimed to assess the role of major perioperative risk factors (age, preoperative PSA values, body mass index, pathologic T-stage, resection status, and ISUP grade) in predicting biochemical recurrence (BCR) and survival after radical prostatectomy (RP) for prostate cancer (PC).

Methods: An analysis of the prospective cohort of patients undergoing RP from 2013 to 2023 at our center was performed. Patients who received neoadjuvant or adjuvant therapies for PC or those with PSA persistence after RP were excluded. A Cox regression analysis was undertaken to evaluate the effect of major perioperative risk factors on the time to BCR. The role of the EAU BCR risk stratification on survival was also assessed. For all analyses, hazard ratios (HRs) with the corresponding 95% confidence intervals (CIs) were estimated.

Results: A total of 1539 patients underwent RP for localized PC. At a median follow-up of 39 months (IQR: 25-60) from RP, 393 (26%) patients developed BCR. Of them, 266 (68%) were classified as EAU BCR high risk and 127 (32%) as EAU BCR low risk. In the multivariate Cox regression analysis, locally advanced PC (HR: 1.5, 95% CI: 1.2-1.9, p<0.001), positive surgical margins (HR: 1.4, 95% CI: 1.1-1.7, p=0.01), as well as ISUP grade 3 (HR: 2.4, 95% CI: 1.5-3.6, p<0.001) and 4 (HR: 2.4, 95% CI: 1.5-3.7, p<0.001) were associated with worse time to BCR. Overall, 16 (1%) patients died. Of them, 13 (81%) were classified as EAU BCR high risk and 3 (19%) as EAU BCR low risk (p<0.001). In the univariate Cox regression analysis, patients with EAU BCR high risk presented worse overall survival (HR: 4.9, 95% CI: 1.4-17, p=0.014).

Conclusion: Locally advanced PC, positive surgical margins, and worse ISUP grade are independent risk factors for BCR. Accordingly, patients at BCR high-risk based on the EAU risk stratification present worse overall survival.

Keywords: biochemical recurrence; overall survival; prostate cancer; prostatectomy.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Kaplan-Meier curves for BCR in patients undergoing radical prostatectomy for localized prostate cancer based on the T-stage (A), surgical margins (B), and ISUP grade (C).
Figure 2
Figure 2
Kaplan-Meier curves for overall survival in patients undergoing radical prostatectomy for localized prostate cancer based on the EAU biochemical recurrence risk stratification.
See this image and copyright information in PMC

References

    1. Siegel RL, Giaquinto AN, Jemal A. Cancer statistics, 2024. CA Cancer J Clin. 2024;74:12–49. doi:10.3322/caac.21820 - DOI - PubMed
    1. Pompe RS, Gild P, Karakiewicz PI, et al. Long-term cancer control outcomes in patients with biochemical recurrence and the impact of time from radical prostatectomy to biochemical recurrence. Prostate. 2018;78:676–681. doi:10.1002/pros.23511 - DOI - PubMed
    1. Boorjian SA, Thompson RH, Tollefson MK, et al. Long-term risk of clinical progression after biochemical recurrence following radical prostatectomy: the impact of time from surgery to recurrence. Eur Urol. 2011;59:893–899. doi:10.1016/j.eururo.2011.02.026 - DOI - PubMed
    1. Pound CR, Partin AW, Eisenberger MA, et al. Natural history of progression after PSA elevation following radical prostatectomy. JAMA. 1999;281:1591–1597. doi:10.1001/jama.281.17.1591 - DOI - PubMed
    1. Van den Broeck T, van den Bergh RCN, Briers E, et al. Biochemical recurrence in prostate cancer: the European Association of Urology prostate cancer guidelines panel recommendations. Eur Urol Focus. 2020;6:231–234. doi:10.1016/j.euf.2019.06.004 - DOI - PubMed

LinkOut - more resources