TAIPEI, TAIWAN (UroToday.com) - Introduction and Objectives: To report the longterm oncological outcome associated with radical prostatectomy (RP) in a consecutive cohort of patients with high-risk prostate cancer (PC) and to identify the variables associated with disease progression.
Methods: Between 1998 and 2006, a total of 239 patients underwent RP for high-risk PC. High-risk PC was defined as follows: prostate-specific antigen (PSA) level > 20 ng/mL, Gleason score 8– 10, and/or clinical stage T2c-T4 disease. Biochemical recurrence (BCR) was defined as a postoperative PSA value ≥ 0.20 ng/mL and a confirmatory rise, or a postoperative PSA ≥ 0.20 ng/mL while receiving salvage treatment. Kaplan-Meier and multivariate cox regression analysis were used to determine BCR, cancer specific survival (CSS) and the significant predictors of BCR.
Results: The median follow-up was 64 months. Organ-confined disease, seminal vesicle invasion and lymph node metastasis were reported in 46% (64% corresponded to pT3), 27% and 3%, respectively. The positive surgical margin rate was 29%. Overall, the predicted 5-year and 10-year BCR-free survival rates were 31% and 29%, respectively; and the predicted 5-year and 10-year CSS rates were 98% and 89%, respectively. After adjusting for other covariates, higher pathologic stage, positive nodes, positive surgical margins and Gleason 8–10 are significantly associated with BCR.
Conclusions: Our data support evidence that RP can result in encouraging long-term oncologic outcomes for the management of high- risk PC.
Source of Funding: None
|Listen to an interview with Eric Barret, one of the authors of this study.|
Presented by Eric Barret,1 Youness Ahallal,1 Rafael Sanchez-Salas,1 Fernando Secin,2 Laurent Mascle,1 Petr Macek,1 Luca Lunelli,1 Camilo Gieledman,1 Marc Galiano,1 Francois Rozet,1 and Xavier Cathelineau1 at the 32nd World Congress of Endourology & SWL - September 3 - 7, 2014 - Taipei, Taiwan
1Department of Urology, Institut Montsouris- Paris-Descartes University, Paris, France
2Department of Urology, San Lazaro Foundation and CEMIC, Buenos Aires, Argentina