Outcome of Prostate Cancer Patients with Initial PSA ≥ 20 ng/ml Undergoing Radical Prostatectomy
| Autor: | Stefan Siemer, Michael Stoeckle, Bernd Wullich, Joern Kamradt, Henrik Suttmann, Jan Lehmann, Ulrike Zwergel, Thomas Schroeder |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Male Nephrology medicine.medical_specialty Urology medicine.medical_treatment urologic and male genital diseases Prostate cancer Internal medicine medicine Humans In patient Survivors Stage (cooking) Aged Neoplasm Staging Retrospective Studies Prostatectomy business.industry Prostatic Neoplasms Middle Aged Prostate-Specific Antigen medicine.disease Survival Analysis Surgery Prostate-specific antigen Treatment Outcome Cohort Hormonal therapy business |
| Zdroj: | European Urology. 52:1058-1066 |
| ISSN: | 0302-2838 |
| Popis: | Objectives To retrospectively assess the outcome of patients with initial PSA of 20ng/ml or higher undergoing radical prostatectomy (RP) for prostate cancer (pCA). Methods Between January 1986 and June 2005, 275 patients with preoperative PSA≥20ng/ml underwent RP for pCA at our institution. Overall, disease-specific and biochemical progression-free survival rates for the entire cohort and for particular subgroups were determined. Results Median patient age at time of surgery was 64 yr (range: 44–75). Fifty-seven patients (20.7%) had pT2 stage, 206 (74.9%) pT3, and 10 (3.7%) pT4; 78 (28.4%) presented with local nodal metastases (pN+). To date, 40 patients have died (14.5%), 22 of pCA and 18 of other causes. Biochemical progression occurred in 92 patients (33.5%). Overall (and disease-specific) survivals at 5, 10, and 15 yr were 87% (93%), 70% (83%), and 58% (71%), respectively. These survival rates did not significantly differ between patients receiving immediate versus deferred hormonal therapy (in case of progression). Five-year PSA progression-free survival in patients on surveillance (receiving deferred hormonal treatment at the onset of rising PSA values) was 53%. For patients on immediate hormonal treatment following RP, the 5-yr hormone-refractory PSA progression rate was 76%. Conclusions According to long-term follow-up results in this high-risk cohort of patients with preoperative PSA≥20ng/ml, RP can be considered a viable therapeutic option. With regard to combining immediate hormonal therapy with surgery, the optimal treatment following RP remains to be defined. |
| Databáze: | OpenAIRE |
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