Survival after radical retropubic prostatectomy of men with clinically localized high grade carcinoma of the prostate

✍ Scribed by Michael G. Oefelein; John T. Grayhack; Kevin T. McVary

• Publisher: John Wiley and Sons
• Year: 1995
• Tongue: English
• Weight: 771 KB
• Volume: 76
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/1097-0142(19951215)76:12<2535::aid-cncr2820761220>3.0.co;2-q

✦ Synopsis

Background. This study was performed to evaluate the efficacy of radical prostatectomy for men with clinically localized, poorly differentiated (Gleason score 2 7 ) prostate cancer and to characterize further the prognostic significance of traditional pathologic variables. The effectiveness of adjuvant radiotherapy was assessed in a subpopulation of men for whom the pathologic assessment suggested a high risk of persistent disease.

Methods. Two hundred thirty-eight consecutive men, 74 of whom had clinically localized, poorly differentiated carcinoma, were followed for a median of 6.2 and 5.1 years, respectively. The disease specific outcomes were derived from a non-prostate specific antigen (PSA) screened population.

Results. The 5-year disease specific survival (DSS) for 52 men with a clinically localized Gleason score of 7 and for 22 men with a Gleason score greater than or equal to 8 carcinoma was 92% and 79%, respectively. The 5-year likelihood of having an undetectable PSA level was 50% for those with a Gleason score of 7 and 38% for those with a Gleason score greater than or equal to 8. Gleason score was the most powerful pathologic predictor of disease progression and survival. Pathologic stage was significantly associated with disease progression for carcinomas with Gleason scores less than 7 but was found to be less predictive of progression for carcinomas with Gleason scores greater than or equal to 7. Adjuvant radiotherapy provided a significantly reduced risk of PSA-detectable progression (P = 0.02, relative risk = 0.56, 95% CI: