Outcome of radical prostatectomy as primary treatment for high‑risk prostate cancer patients.
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Date
2015-10
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Abstract
CONTEXT: Recently, there has been considerable interest in the role of radical prostatectomy (RP) in men with high‑risk prostate cancer. AIMS: The
objective of our study is to report the outcome of upfront RP in our patients with high‑risk prostate cancer (Stage ≥ cT2c, a pre‑operative serum
prostate specific antigen >20 ng/ml or a biopsy Gleason score [GS] 8‑10). SUBJECTS AND METHODS: From 1996 to 2010, 208 patients of prostate
cancer (high risk category D’Amico’s criteria) underwent open RP with bilateral pelvic lymphadenectomy. STATISTICAL ANALYSIS USED: The data
was statistically analyzed using Kaplan Meier method and log rank test to calculate progression free, metastasis free survival (MFS) and cancer
specific survival (CSS). Furthermore multivariate analysis (MVA) was carried out using SPSS 14 software. (IBM company). RESULTS: At 7 and
10 years, prostate cancer‑specific survival (PCSS) was found to be 79.7% and 65%, respectively, biochemical recurrence free survival (BRFS)
was 42.4% and 36.7%, respectively and the MFS was 71.1% and 64.4% respectively. High GS was highly predictable of PCSS, BRFS and MFS.
Node positivity was the single poor risk factor on MVA whereas biopsy GS, pStage (P = 0.016) and seminal vesicle invasion (P = 0.045) had
statistical significance in predicting the MFS. CONCLUSIONS: RP provides accurate pathologic staging of patients with high risk prostate cancer,
allows better stratification of patients for further adjuvant therapy and either as an initial approach or part of a multimodal regimen, can provide
durable local control and provides excellent CSS.
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Keywords
High‑risk prostate cancer, radical prostatectomy, D’Amico criteria
Citation
Kulkarni J N, Gunavanthe V S, Dhale A. Outcome of radical prostatectomy as primary treatment for high‑risk prostate cancer patients. Indian Journal of Cancer. 2015 Oct-Dec; 52(4): 646-652.