Predictive Value of Preoperative Prostate Health Index and Serum Testosterone Testing for Biochemical Recurrence after Radical Prostatectomy for Non-Metastatic Prostate Cancer

ABSTRACT

Objective: To analyse the predictive value of prostate health index (PHI) combined with serum testosterone after radical prostatectomy(RP) for prostate cancer (PCa).Methods: A total of 132 PCa patients who received RP treatment from January 2016 to December 2019 were selected, retrospectively.And then these patients were divided into biochemical recurrence (BCR) group (n = 51) and non-biochemical recurrence(non-BCR) group (n = 81) based on whether BCR was present after RP. Basic data of PCa patients were collected, and preoperativeprostate health index (PHI) and serum testosterone levels were measured in both groups. Logistic regression analysiswas used to analyse the influencing factors of BCR after RP. The predictive value of PHI and serum testosterone on BCR afterRP was analysed using the receiver operating characteristic (ROC) curve. The Kaplan–Meier method was used to plot survivalcurves, and log rank test was used to analyse the differences between survival curves.Results: The BCR rate of patients in this study was 38.64% (51/132). Single-factor analysis showed that BCR after RP in PCapatients was associated with prostate-specific antigen (PSA), Gleason score, pathological stage, postoperative adjuvant therapy,testosterone and PHI (p < 0.05). Logistics regression analysis showed that PSA >20 ng/mL, Gleason score (8 scores), pathologicalstage pT3, increased PHI and increased testosterone were independent risk factors for BCR after RP. ROC curve analysisshowed that the area under curve (AUC) of PHI and serum testosterone predicting BCR after RP alone and in combination were0.769, 0.725 and 0.906, respectively. Kaplan–Meier survival analysis showed that preoperative high PHI and low testosteroneare negatively correlated with recurrence-free survival rate. (AU)