The Risk Factors Analysis Of Clinical Recurrence After Radical Prostatectomy

Objectives: Prostate cancer is a kind of clinical common malignant tumor,Although there are treatments varied,including: the surgical treatment and non-surgical treatment.The non-surgical treatments include endocrine therapy,chemotherapy,radiation therapy,close irradiation treatment,experimental treatment of prostate cancer.with the progress of science and technology,the ascension of surgical skills,lower incidence of surgical complications,clinicians are gradually enlarging radical prostatectomy surgery indications.the majority of patients with prostate cancer choice the treatment option for radical prostatectomy.But in specific clinical practice,we found that many patients with prostate cancer after radical prostatectomy is easily occurred clinical relapse.As this kind of situation,this article through to the patients undergoing radical prostatectomy were retrospectively investigation and study,in order to make clear what are the clinical or pathological index is a risk factor for recurrence of clinical oncology,and risk factors of postoperative patients with close follow-up,guiding the early diagnosis and adjuvant therapy.Materials and Methods :By using the method of retrospective analysis,we analysis the clinical data of 61 patients with prostate cancer who underwent radical prostatectomy in the second affiliated hospital of dalian medical university between January 2011 to January 2016.12 patients with postoperative pathologic stage T1,T2 stage of 23 cases of the patients,26 patients with T3 and more.We Observe the effect of patient’s age,prostate specific antigen,prostatic volume,postoperative Gleason score,clinical stage,Vascular invasion,lymph node metastasis status and Positive Surgical Margin after radical prostatectomy.Statistical methods: The measurement data using chi-square test,multiple factors analysis using Logistic regression analysis.Results: 1.The univariate analysis showed that patient’s age,prostate volume and vascular invasion differences in postoperative clinical recurrence was not statistically significant.Clinical stage,prostate specific antigen,postoperative Gleason score,lymph node metastasis and positive surgical margin differences in clinical recurrence were statistically significant.2.The multiple-factor analysis revealed that postoperative Gleason score,lymph node metastasis states and positive surgical margin status were independent predictors of clinical recurrence after radical prostatectomy.Increasing postoperative Gleason score for each level the risk of postoperative clinical recurrence rise 2.003 times(OR is 2.003,95% CI 0.528 to 7.595);The risk of clinical recurrence with lymph node metastasis after surgery is 2.647 times without lymph node metastasis(OR value 2.647,95% CI 2.140 ~ 4.983);The risk of clinical recurrence with positive surgical margin after surgery was negative margins1.845 times(OR value of 1.845,95% CI 1.228 ~ 4.124).Conclusions: Postoperative Gleason score,positive lymph node metastasis and positive surgical margins are independent factors of the patients with clinical recurrence after radical prostatectomy.The patients with Postoperative Gleason score ≥ 8,positive lymph node metastasis and positive surgical margins,whose the risk of postoperative clinical recurrence was significantly increased.The patients with negative lymph node,negative surgical margin,high Gleason score,who should choose close follow-up or hormonal therapy as early as possible.