OBJECTIVES: To assess the lymph node metastasis-free survival, distant metastasis-free survival and disease-specific survival in men with Gleason score ≤ 6 prostate cancer on radical prostatectomy.
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PATIENTS AND METHODS: We included 1101 consecutive radical prostatectomy patients operated between March 1985 to July 2013 at a single institution. The outcome variables were metastasis-free survival and disease-specific survival. The postoperative survival was estimated by the Kaplan-Meier method.
RESULTS: The Gleason score distribution of the study population (n=1101) was Gleason score ≤ 6 (n=449, 41%), Gleason score 3+4=7 (n=436, 40%), Gleason score 4+3=7 (n=99, 9%) and Gleason score 8-10 (n=117, 11%). The median post-operative follow-up was 100 months (IQR 48-150). During follow-up 197 men (18%) died of whom 42 (3.8%) from prostate cancer related causes. A total of 19/1101 patients (1.7%) had documented lymph node metastasis at time of operation: 0 in Gleason score ≤ 6, 7 in Gleason score 3+4=7 (1.6%), 6 in Gleason score 4+3=7 (6.1%) and 6 in Gleason score 8-10 (5.1%). Distant metastasis occurred in 56/1101 patients (5.1%): 0 in Gleason score ≤ 6, 23 in Gleason score 3+4=7 (5.3%), 17 in Gleason score 4+3=7 (17%) and 16 in Gleason score 8-10 (14%). Disease-specific death, stratified per Gleason score group was: 0 in ≤ 6, 16 (3.7%) in 3+4=7, 16 (16%) in 4+3=7 and 10 (8.5%) in 8-10.
CONCLUSION: No metastasis or disease-specific death were observed in men with Gleason score ≤ 6 prostate cancer on radical prostatectomy, demonstrating the negligible potential to metastasize in this large subgroup of prostate cancer patients.
Kweldam CF, Wildhagen MF, Bangma CH, van Leenders GJ. Are you the author?
Department of Pathology, Erasmus Medical Center, Rotterdam, The Netherlands.
Reference: BJU Int. 2014 Jul 25. Epub ahead of print.