AUA 2011 - RRP as stand-alone therapy for high-risk prostate cancer - Session Highlights

WASHINGTON, DC USA (UroToday.com) - Dr. Steven Joniau presented multi-institutional data that among select patients with high-risk prostate cancer (CaP), surgery alone has good outcomes.

The study aim was to investigate the cancer specific survival (CSS) of high-risk localized CaP patients who underwent surgery alone without adjuvant treatment. The database included 1,747 patients with pre-operative high-risk CaP (PSA>20 ng/ml or cT3-4 or biopsy Gleason 8-10) treated with radical retropubic prostatectomy (RRP) and pelvic LND at 9 tertiary referral centers between 1987 and 2009. Patients receiving neo-adjuvant or adjuvant (within 3 months) treatment were excluded from the analysis. Salvage therapy was administered according to institutional protocols.

A total of 516 patients met inclusion criteria for the analysis. Mean age at surgery was 64.8 yrs and mean pre-operative PSA was 20.7ng/ml. Final Gleason sum was 2-6, 7 and 8-10 in 32.8, 45.6 and 21.6%, respectively. Pathological stage was T2, T3a and >T3a in 37.1%, 43.1% and 19.8%, respectively. Margins were positive in 25.0%, and lymph nodes were positive in 8.2%. Salvage RT and HT were delivered to 19.0% and 20.3%, respectively. Overall, 322/516 (62.3%) patients had specimen confined CaP and had an excellent 10-year CSS compared to those without specimen confined CaP (97.1% vs. 91.0%, p=0.006). They were also less likely to receive salvage RT (13.2 vs. 30.1%, p<0.0001) and HT (8.7 vs. 41.6%, p<0.0001). Furthermore, patients who experienced biochemical recurrence within 24 months of surgery (21.1%) fared significantly worse compared to patients who experienced BR beyond 24 months (18.0%); the10-year CSS was 82.2% vs. 95.4%, respectively, p<0.0001.

 

 

Presented by Steven Joniau, et al. at the American Urological Association (AUA) Annual Meeting - May 14 - 19, 2011 - Walter E. Washington Convention Center, Washington, DC USA


Reported for UroToday by Christopher P. Evans, MD, FACS, Professor and Chairman, Department of Urology, University of California, Davis, School of Medicine.


 

The opinions expressed in this article are those of the UroToday.com Contributing Editor and do not necessarily reflect the viewpoints of the American Urological Association.


 

 



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