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Radical prostatectomy for high‐risk prostate cancer: Biochemical outcome
Author(s) -
Kawamorita Naoki,
Saito Seiichi,
Ishidoya Shigeto,
Ito Akihiro,
Saito Hideo,
Kato Masanori,
Arai Yoichi
Publication year - 2009
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.2009.02352.x
Subject(s) - medicine , prostatectomy , prostate cancer , urology , radical retropubic prostatectomy , biopsy , prostate specific antigen , surgical margin , cancer , prostate , oncology
Objectives: To determine the biochemical outcome following radical prostatectomy alone in patients with high‐risk prostate cancer. Methods: Between January 2002 and August 2007, 252 patients underwent radical retropubic prostatectomy. Those who received neoadjuvant hormone therapy were excluded from this analysis. Based on pre‐operative data, we stratified the patients into low, intermediate, and high‐risk groups according to the risk criteria of the National Comprehensive Cancer Network in 2003, respectively. Prostate‐specific antigen (PSA) failure was defined as any detectable PSA level higher than 0.2 ng/mL. Results: The PSA failure‐free survival rate for the high‐risk group ( n = 46) was 64.5% after a median follow‐up period of 39 months. Among patients with high‐risk disease, none with pathologically organ‐confined cancer ( n = 19) and a negative surgical margin had PSA failure. The PSA failure‐free rate in patients with non organ‐confined cancer ( n = 27) was 39.5%. Among the pretreatment variables, a positive biopsy core percentage (the number of positive biopsy cores/total biopsy core) ≥30 was a significant independent predictor of extra prostatic extension. Conclusions: Radical prostatectomy is feasible in high‐risk prostate cancer patients, only if they have a pathologically organ‐confined disease.