Determining the Cut-off Values of Tumor Diameter, Degree of Extraprostatic Extension, and Extent of Surgical Margin Positivity with Regard to Biochemical Recurrence of Prostate Cancer after Radical Prostatectomy

Background: The pre-biopsy (bx) prostate-specific antigen (PSA) level, tumor volume/diameter, degree of extraprostatic extension (EPE), and extent of surgical margin positivity have been shown to be significant prognostic parameters of biochemical recurrence (BCR) after radical prostatectomy. The present study assessed the cut-off values of the pre-bx PSA level, maximum tumor diameter, radial and circumferential distances of EPE, and circumferential length of surgical margin (SM) positivity with regard to BCR. Material and methods: The study included 445 radical prostatectomy specimens, and the cut-off values of all parameters were determined using receiver operating characteristic curve analysis. Results: An ISUP grade group >= 3, radial distance of EPE > 1 mm, and circumferential length of SM positivity >= 2 mm were identified as independent predictors of BCR after radical prostatectomy. The parameters that showed statistical significance in univariate analysis, such as pre-bx PSA level >= 7.20 ng/mL, tumor diameter >= 19.5 mm, presence of seminal vesicle invasion, and circumferential distance of EPE > 3 mm, did not have independent prognostic values for BCR. Conclusions: An ISUP grade group >= 3, radial distance of EPE > 1 mm, and circumferential length of SM positivity >= 2 mm are predictors of BCR. Our findings might have significance in risk classification and adjuvant therapy consideration among patients with localized prostate cancer.