OBJECTIVE: • To investigate the pathological characteristics and the rates of biochemical recurrence (BCR) -free survival after radical prostatectomy (RP) in men with high-risk prostate cancer. METHODS: • Of 4760 patients treated with RP for prostate cancer at three institutions, 293 patients (6.2%) had clinical stage T3, 269 (5.7%) had a biopsy Gleason sum ≥ 8, 370 (7.8%) had preoperative PSA ≥ 20 ng/mL and 887 (18.6%) were considered high-risk according to the D'Amico classification (clinical stage ≥ T2c or prostate-specific antigen (PSA) ≥ 20 ng/mL or biopsy Gleason sum ≥ 8). • Actuarial BCR-free survival probabilities after RP and the rate of favourable pathology (organ-confined cancer, negative surgical margin and Gleason ≤ 7) were assessed. RESULTS: • Median follow up was 2.4 years and 1179 (24.8%) patients had follow up beyond 5 years. • The rate of favourable pathology increased in the following order: clinical stage T3 (13.7%), biopsy Gleason ≥ 8 (16.4%), the D'Amico high-risk group (21.4%) and PSA ≥ 20 ng/mL (21.6%). • The 5-year BCR-free survival probabilities were 35.4% for Gleason ≥ 8, 39.8% for PSA ≥ 20 ng/mL, 47.4% for D'Amico high-risk group and 51.6% for clinical stage T3. • Patients with only one risk factor had the most favourable 5-year BCR-free survival (50.3%), relative to patients with two or more risk factors (27.5%) CONCLUSIONS: • Men with clinically localized high-risk prostate cancer do not have a uniformly poor prognosis after RP. • The rate of favourable pathology and of BCR-free survival may vary substantially, depending on the definition used. • RP should be considered a valid treatment modality for high-risk prostate cancer patients, as many can be surgically down-staged.
OBJECTIVE: • To investigate the pathological characteristics and the rates of biochemical recurrence (BCR) -free survival after radical prostatectomy (RP) in men with high-risk prostate cancer. METHODS: • Of 4760 patients treated with RP for prostate cancer at three institutions, 293 patients (6.2%) had clinical stage T3, 269 (5.7%) had a biopsy Gleason sum ≥ 8, 370 (7.8%) had preoperative PSA ≥ 20 ng/mL and 887 (18.6%) were considered high-risk according to the D'Amico classification (clinical stage ≥ T2c or prostate-specific antigen (PSA) ≥ 20 ng/mL or biopsy Gleason sum ≥ 8). • Actuarial BCR-free survival probabilities after RP and the rate of favourable pathology (organ-confined cancer, negative surgical margin and Gleason ≤ 7) were assessed. RESULTS: • Median follow up was 2.4 years and 1179 (24.8%) patients had follow up beyond 5 years. • The rate of favourable pathology increased in the following order: clinical stage T3 (13.7%), biopsy Gleason ≥ 8 (16.4%), the D'Amico high-risk group (21.4%) and PSA ≥ 20 ng/mL (21.6%). • The 5-year BCR-free survival probabilities were 35.4% for Gleason ≥ 8, 39.8% for PSA ≥ 20 ng/mL, 47.4% for D'Amico high-risk group and 51.6% for clinical stage T3. • Patients with only one risk factor had the most favourable 5-year BCR-free survival (50.3%), relative to patients with two or more risk factors (27.5%) CONCLUSIONS: • Men with clinically localized high-risk prostate cancer do not have a uniformly poor prognosis after RP. • The rate of favourable pathology and of BCR-free survival may vary substantially, depending on the definition used. • RP should be considered a valid treatment modality for high-risk prostate cancerpatients, as many can be surgically down-staged.
Authors: Andreas Becker; Carolina Coelius; Meike Adam; Pierre Tennstedt; Luis Kluth; Thomas Steuber; Hans Heinzer; Markus Graefen; Thorsten Schlomm; Uwe Michl Journal: World J Urol Date: 2014-03-26 Impact factor: 4.226
Authors: Nicola Fossati; Niccolò M Passoni; Marco Moschini; Giorgio Gandaglia; Alessandro Larcher; Massimo Freschi; Giorgio Guazzoni; Daniel D Sjoberg; Andrew J Vickers; Francesco Montorsi; Alberto Briganti Journal: BJU Int Date: 2015-06-10 Impact factor: 5.588
Authors: A Sivaraman; G Ordaz Jurado; X Cathelineau; Eric Barret; P Dell'Oglio; S Joniau; M Bianchi; A Briganti; M Spahn; P Bastian; J Chun; P Chlosta; P Gontero; M Graefen; R Jeffrey Karnes; G Marchioro; B Tombal; L Tosco; H Henk van der Poel; R Sanchez-Salas Journal: World J Urol Date: 2016-02-20 Impact factor: 4.226
Authors: F Moltzahn; J Karnes; P Gontero; B Kneitz; B Tombal; P Bader; A Briganti; F Montorsi; H Van Poppel; S Joniau; M Spahn Journal: Prostate Cancer Prostatic Dis Date: 2014-12-23 Impact factor: 5.554