Long-term outcomes of radical prostatectomy with multimodal adjuvant therapy in men with a preoperative serum prostate-specific antigen level > or =50 ng/mL.

Autor:	Inman, Brant A., Davies, Judson D., Rangel, Laureano J., Bergstralh, Eric J., Kwon, Eugene D., Blute, Michael L., Karnes, R. Jeffrey, Leibovich, Bradley C.
Předmět:	PROSTATECTOMY PROSTATE cancer PROSTATE-specific antigen CANCER-related mortality PATHOLOGY PROSTATE tumors treatment CANCER relapse COMBINED modality therapy COMPARATIVE studies RESEARCH methodology MEDICAL cooperation PROGNOSIS PROSTATE tumors RESEARCH SURVIVAL EVALUATION research DISEASE progression
Zdroj:	Cancer (0008543X); Oct2008, Vol. 113 Issue 7, p1544-1551, 8p, 3 Charts, 4 Graphs
Abstrakt:	Background: The authors evaluated the long-term outcomes of men with prostate cancer and very high (> or =50 ng/mL) preoperative serum prostate-specific antigen (PSA) values that were treated with radical prostatectomy.Methods: This study included 236 men with preoperative serum PSA values > or =50 ng/mL who underwent radical retropubic prostatectomy between 1987 and 2004. For comparison, the study cohort was divided into 2 groups: patients with PSA levels between 50 and 99 ng/mL and patients with PSA levels > or =100 ng/mL. Biochemical recurrence was defined as a single postoperative serum PSA value of 0.4 ng/mL or greater. Systemic disease progression was defined as the development of a local recurrence or systemic metastases, and any death resulting from prostate cancer or its treatment was defined as a cancer-specific mortality.Results: Biochemical recurrence-free survival rates in the groups of patients with a PSA level 50 to 99 ng/mL and > or =100 ng/mL were 43% and 36% at 10 years, respectively. Systemic progression-free survival rates in the PSA 50 to 99 ng/mL and PSA > or =100 ng/mL groups were 83% and 74% at 10 years, respectively. Estimated overall cancer-specific survival was 87% at 10 years.Conclusions: Patients with prostate cancer and a serum PSA level > or =50 ng/mL have very high-risk prostate cancer that carries a high likelihood of being pathologically advanced. Although the probability of realizing long-term survival in these high-risk patients is less than in patients with more favorable disease, 10-year survival outcomes remain excellent and argue for aggressive management of these cases. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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