Risk of biochemical recurrence in patients with GG1PC with extraprostatic extension treated with radical prostatectomy

This study examined the association of extraprostatic tumor extension (EPE) with biochemical recurrence (BCR) separately in men with Grade Group (GG)1 and Grade Group (GG)2 prostate cancer treated with radical prostatectomy.

After review of patient records, a cohort of 6309 men (6.2% with GG1 disease and EPE and 28.4% with GG2 disease and EPE were identified.

For men with GG1 there was no statistically significant difference in biochemical recurrence (BCR).

For GG2 patients, BCR-free survival was significantly worse for those with, versus without EPE. The subdistribution HR of 1.97 indicates that GG2 patients with EPE were nearly twice as likely to experience biochemical recurrence compared to those without EPE.

Thus, although there is a subset of GG1 prostate cancer capable of invading through the prostatic capsule, patients with GG1 prostate cancer and EPE at prostatectomy experience similar recurrence and survival outcomes compared to GG1 patients without EPE. However, among men with GG2, EPE suggests a worse prognosis.

Findings suggest that patients with GG1 tumors and EPE experience similar risk of BCR after surgery compared to those without EPE and provide further evidence that GG1 PC is generally a low-risk disease process even when tumors invade beyond the prostatic capsule.

The Journal of Urology. 2024 March. https://doi.org/10.1097/JU.0000000000003825