1325 LONG-TERM OUTCOMES OF RADICAL PROSTATECTOMY FOR PT3BN0M0 PROSTATE CANCER IN THE PROSTATE SPECIFIC ANTIGEN SCREENING ERA

Abstract

You have accessJournal of UrologyProstate Cancer: Localized VI1 Apr 20121325 LONG-TERM OUTCOMES OF RADICAL PROSTATECTOMY FOR PT3BN0M0 PROSTATE CANCER IN THE PROSTATE SPECIFIC ANTIGEN SCREENING ERA Adrian Fairey, Siamak Daneshmand, Isuru Jayaratna, Eila Skinner, Anne Schuckman, Jie Cai, and Gary Lieskovsky Adrian FaireyAdrian Fairey Los Angeles, CA More articles by this author , Siamak DaneshmandSiamak Daneshmand Los Angeles, CA More articles by this author , Isuru JayaratnaIsuru Jayaratna Los Angeles, CA More articles by this author , Eila SkinnerEila Skinner Los Angeles, CA More articles by this author , Anne SchuckmanAnne Schuckman Los Angeles, CA More articles by this author , Jie CaiJie Cai Los Angeles, CA More articles by this author , and Gary LieskovskyGary Lieskovsky Los Angeles, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1707AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We evaluated long-term outcomes of radical prostatectomy for pT3bN0M0 prostate cancer in the era of prostate-specific antigen (PSA) screening. METHODS A retrospective analysis of prospectively collected data from the University of Southern California Prostate Cancer Database was performed. Between 1987 and 2008, 229 men underwent open radical prostatectomy for pT3bN0M0 (seminal vesicle invasion) prostate cancer. The cohort was divided into early (1987-1997) and contemporary (1998-2008) PSA eras. The outcomes were overall survival (OS), clinical recurrence-free survival (cRFS), and biochemical recurrence-free survival (bRFS). The Kaplan-Meier method and Cox proportional regression models were used to analyze survival data. RESULTS The median follow-up duration was 14.5 years (range, 0.2 to 21.1 years). The predicted 10-year OS, cRFS, and bRFS rates for patients treated in the early and contemporary PSA eras were 65% and 67% (Log rank p=0.222), 73% and 95% (Log rank p<0.001), and 65% and 73% (Log rank p=0.055), respectively. Multivariable analysis showed that age (HR 2.12, 95% CI 1.33 to 3.38, p=0.002) and pathologic Gleason grade 8-10 (HR 2.06, 95% CI 1.09 to 3.89, p=0.026) were independently associated with OS whereas pathologic Gleason grade 8-10 (cRFS: HR 5.11, 95% CI 1.72 to 15.20, p=0.003; bRFS: HR 3.47, 95% CI 1.60 to 7.48, p=0.002) and PSA era (cRFS: HR 0.15, 95% CI 0.06 to 0.41, p<0.001; bRFS: HR 0.49, 95% CI 0.28 to 0.86, p=0.013) were independently associated with cRFS and bRFS. Adjuvant radiation therapy and positive surgical margins were not associated with outcomes. CONCLUSIONS Radical prostatectomy conferred long-term cancer control in men with pT3bN0M0 prostate cancer treated in the PSA era. Pathologic Gleason grade 8-10 and treatment in the early PSA era were independently associated with poorer survival outcomes. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e537 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Adrian Fairey Los Angeles, CA More articles by this author Siamak Daneshmand Los Angeles, CA More articles by this author Isuru Jayaratna Los Angeles, CA More articles by this author Eila Skinner Los Angeles, CA More articles by this author Anne Schuckman Los Angeles, CA More articles by this author Jie Cai Los Angeles, CA More articles by this author Gary Lieskovsky Los Angeles, CA More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...