Prostate Cancer: Localized: Surgical Therapy VI (MP64): Moderated Poster 64: Monday, September 13, 2021
MP64-10 HOW LONG SHOULD UROLOGISTS OBSERVE PATIENTS WITH PROSTATE CANCER AFTER RADICAL PROSTATECTOMY?: WEIBULL ANALYSIS
INTRODUCTION AND OBJECTIVE:
There is no recommended observation time for patients who have undergone radical prostatectomy for prostate cancer. This study was undertaken to determine the postoperative observation time by investigating the hazard rate (HR) for biochemical recurrence (BCR) defined by prostate-specific antigen failure and other-cause death using Weibull analysis.
We included 612 patients who underwent laparoscopic radical prostatectomy for localized prostate cancer between June 2002 and December 2017. Risk classification was categorized by D’Amico risk classification, and the patients were divided into three age groups: <60, 60-69, and ≥70 years. The HRs at each point were derived using Weibull analysis. The optimal observation time after laparoscopic radical prostatectomy was determined as the intersection point at which the HR of other-cause death overtakes the HR of BCR.
In all groups classified by age, the HR of other-cause deaths increased over time. The ≥70 age group showed the highest HR, and 2.3 times higher HR of other-cause death than those of ≤ 60 y/o. In contrast, the HR of BCR decreased gradually. The HR of BCR was highest in the high-risk group, and 2.9 times higher HR of developing BCR than low-risk patients. Based on these two Weibull models, we revealed the age- and risk-specific time points when the other-cause death risk exceeded that of BCR. The ≥70 and 60-69 year-old patients in the low-risk group required 6 years 6 months and 14 years 4 months, respectively, for observation. The remaining patients required over 20 years of postsurgical observation.
The observation time following laparoscopic radical prostatectomy could be estimated by comparing the estimated HRs of BCR and other-cause death based on Weibull analysis. Urologists should pay attention to age and risk classifications for optimal postoperative observation.
Source of Funding:
None© 2021 by American Urological Association Education and Research, Inc.