SIU 2017: Conditional Probability of Biochemical Recurrence-Free Survival and Cancer-Specific Mortality after Radical Prostatectomy at Long Term Follow-Up

Lisbon, Portugal ( When it comes to counseling patients, we are often struggling to provide patients with updated survival benefits as they move further out from initial intervention. While our initial survival data is well established, as patients are further removed from their treatment, their survival estimates change – often for the better.

In this study, the group from France utilize their 16 year experience of 6195 men treated with RP (robotic or laparoscopic) for clinically localized prostate cancer. They excluded patients with any evidence of LN metastases, cT or cT4, or adjuvant therapy before diagnosis of biochemical recurrence (BCR) [PSA > 0.2].

Oncologic outcomes: BCR-free survival, Cancer-specific survival. They also ran MV analysis for predictors of BCR and cancer-specific mortality.

Below are KM curves assessing BCR over time. 10-year BCR-free survival for all comers is 78.8%.
While not surprising, as patients make it further from surgery, their BCR-free survival increases. By 3-years, their risk of being BCR-free at 10-years crosses 90%.

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However, as expected for patients with localized prostate cancer, cancer-specific survival was very high from the get-go. As such, there was no real separation on the KM curves.

On MV analysis, the usual predictors of BCR and cancer-specific survival were present – no major surprises. However, in their experience, even with facility with laparoscopic surgery, patients undergoing laparoscopic prostatectomy had higher BCR rates and higher Cancer-specific mortality.

I personally think excluding patients who got scheduled adjuvant therapy based on pathologic features was a mistake. Including them, as it is a standard care, would have made more sense.

Speaker(s): Silvia García Barreras, France

Institution(s): L’Institut Mutualiste Montsouris, France

Written by: Thenappan Chandrasekar, MD, Clinical Fellow, University of Toronto, twitter: @tchandra_uromd, at the 37th Congress of Société Internationale d’Urologie - October 19-22, 2017- Lisbon, Portugal