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The role of radical prostatectomy in patients with clinically localized prostate cancer and a prostate-specific antigen level >20 ng/ml.
Prostate Cancer Prostatic Dis. 2006; 9(3):239-44.PC

Abstract

OBJECTIVES

To determine the outcome of patients with a serum prostate-specific antigen (PSA) level >20 ng/ml that underwent radical prostatectomy (RP).

METHODS

We retrospectively reviewed the medical records of 147 patients who underwent RP for clinically localized prostate cancer with a pre-treatment PSA (PSApt) >20 ng/ml. Fifty-two patients had positive pelvic lymph nodes and were excluded from analysis. Of 95 patients remaining, 15 were lost to follow-up. Therefore, the study group included 80 patients. The end points for this analysis were biochemical relapse-free survival (bRFS), surgical and post-operative complications and urinary continence. PSApt, pathological grade, surgical margin status, age, clinical stage and immediate androgen ablation were evaluated in a multivariate analysis regarding bRFS.

RESULTS

Forty-nine resected specimens (61.2%) were pathologically classified as pT3 or pT4. After a mean follow-up of 64 months, the estimated 5-year bRFS rate was 58% for the overall group. Immediate androgen ablation was the only independent prognostic factor for biochemical relapse (P=0.001). Concerning the 21 patients who received an immediate androgen ablation after RP, the estimated 5-year bRFS rate was 92%. Complete urinary continence was achieved in 76.5% of patients. Early complications occurred in 13 patients (16.2%).

CONCLUSIONS

Clinically localized prostate cancer with a PSApt >20 ng/ml is considered as having a poor prognosis. However, RP performed in these patients led to an acceptable morbidity and good functional results. Immediate adjuvant hormonal therapy seems mandatory in this setting to improve bRFS.

Authors+Show Affiliations

Department of Urology, University of Ulm, Ulm, Germany. bastide.c@libertysurf.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

16832384

Citation

Bastide, C, et al. "The Role of Radical Prostatectomy in Patients With Clinically Localized Prostate Cancer and a Prostate-specific Antigen Level >20 Ng/ml." Prostate Cancer and Prostatic Diseases, vol. 9, no. 3, 2006, pp. 239-44.
Bastide C, Kuefer R, Loeffler M, et al. The role of radical prostatectomy in patients with clinically localized prostate cancer and a prostate-specific antigen level >20 ng/ml. Prostate Cancer Prostatic Dis. 2006;9(3):239-44.
Bastide, C., Kuefer, R., Loeffler, M., de Petriconi, R., Gschwend, J., & Hautmann, R. (2006). The role of radical prostatectomy in patients with clinically localized prostate cancer and a prostate-specific antigen level >20 ng/ml. Prostate Cancer and Prostatic Diseases, 9(3), 239-44.
Bastide C, et al. The Role of Radical Prostatectomy in Patients With Clinically Localized Prostate Cancer and a Prostate-specific Antigen Level >20 Ng/ml. Prostate Cancer Prostatic Dis. 2006;9(3):239-44. PubMed PMID: 16832384.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The role of radical prostatectomy in patients with clinically localized prostate cancer and a prostate-specific antigen level >20 ng/ml. AU - Bastide,C, AU - Kuefer,R, AU - Loeffler,M, AU - de Petriconi,R, AU - Gschwend,J, AU - Hautmann,R, Y1 - 2006/07/11/ PY - 2006/7/13/pubmed PY - 2007/1/26/medline PY - 2006/7/13/entrez SP - 239 EP - 44 JF - Prostate cancer and prostatic diseases JO - Prostate Cancer Prostatic Dis VL - 9 IS - 3 N2 - OBJECTIVES: To determine the outcome of patients with a serum prostate-specific antigen (PSA) level >20 ng/ml that underwent radical prostatectomy (RP). METHODS: We retrospectively reviewed the medical records of 147 patients who underwent RP for clinically localized prostate cancer with a pre-treatment PSA (PSApt) >20 ng/ml. Fifty-two patients had positive pelvic lymph nodes and were excluded from analysis. Of 95 patients remaining, 15 were lost to follow-up. Therefore, the study group included 80 patients. The end points for this analysis were biochemical relapse-free survival (bRFS), surgical and post-operative complications and urinary continence. PSApt, pathological grade, surgical margin status, age, clinical stage and immediate androgen ablation were evaluated in a multivariate analysis regarding bRFS. RESULTS: Forty-nine resected specimens (61.2%) were pathologically classified as pT3 or pT4. After a mean follow-up of 64 months, the estimated 5-year bRFS rate was 58% for the overall group. Immediate androgen ablation was the only independent prognostic factor for biochemical relapse (P=0.001). Concerning the 21 patients who received an immediate androgen ablation after RP, the estimated 5-year bRFS rate was 92%. Complete urinary continence was achieved in 76.5% of patients. Early complications occurred in 13 patients (16.2%). CONCLUSIONS: Clinically localized prostate cancer with a PSApt >20 ng/ml is considered as having a poor prognosis. However, RP performed in these patients led to an acceptable morbidity and good functional results. Immediate adjuvant hormonal therapy seems mandatory in this setting to improve bRFS. SN - 1365-7852 UR - https://www.unboundmedicine.com/medline/citation/16832384/The_role_of_radical_prostatectomy_in_patients_with_clinically_localized_prostate_cancer_and_a_prostate_specific_antigen_level_>20_ng/ml_ L2 - https://doi.org/10.1038/sj.pcan.4500892 DB - PRIME DP - Unbound Medicine ER -