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A New Predictive Tool for the Post-surgical Risk of Recurrence of Prostate Cancer Potentially Unveiling Hidden Residual Disease

Ilaria Stura, Serena Ditaranto, Domenico Gabriele, Giuseppe Migliaretti and Caterina Guiot

Background: 20-25% of patients affected by prostate cancer relapses in the first 5 years after radical prostatectomy. Risk assessment is normally performed on consolidated parameters relating the peri-operative tumor characteristics, namely tumor staging, nodal involvement, positive margins, pathological Gleason Score and pre-surgery PSA values.

Methods: Based on the EUREKA-1 database, which collected clinical data from a large cohort of prostatectomized Italian patients, we validated three different models, which differ in the splitting of the pGS=7 patients in 3+4 and 4+3 cases and in the inclusion of the first post-surgery PSA value.

Results: Differences in the ROC curves’ AUC were detected, which are highly significant (73%) when the first postsurgical PSA is accounted for in the evaluation of the risk of tumor recurrence.

Conclusions: Early post-surgical PSA evaluation, besides being the starting point for long-time monitoring and a very sensible ‘alarm-bell’ when the biochemical recurrence threshold is approached, is therefore a valuable coparameter for the post-surgical risk assessment for prostate tumor recurrence.