1464 ONCOLOGICAL OUTCOME OF RADICAL PROSTATECTOMY AS MONOTHERAPY FOR JAPANESE MEN WITH HIGH RISK PROSTATE CANCER

Abstract

You have accessJournal of UrologyProstate Cancer: Localized VII1 Apr 20121464 ONCOLOGICAL OUTCOME OF RADICAL PROSTATECTOMY AS MONOTHERAPY FOR JAPANESE MEN WITH HIGH RISK PROSTATE CANCER Junya Furukawa, Hideaki Miyake, and Masato Fujisawa Junya FurukawaJunya Furukawa Kobe, Japan More articles by this author , Hideaki MiyakeHideaki Miyake Kobe, Japan More articles by this author , and Masato FujisawaMasato Fujisawa Kobe, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1985AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Radical prostatectomy (RP) has been shown to result in excellent oncological outcomes for patients with low risk prostate cancer; however, it remains controversial whether RP as monotherapy can effectively control high risk prostate cancer. The objectives of this study were to retrospectively review our experience with RP as monotherapy for Japanese patients with high risk prostate cancer and to identify factors associated with biochemical outcome in these patients. METHODS This study included a total of 382 consecutive patients who were diagnosed as having high risk prostate cancer according to D'Amico definition (PSA 20 ng/ml or greater, cT2c or greater, or biopsy Gleason score 8–10), and subsequently underwent RP and pelvic lymphadenectomy without neoadjuvant therapy between 2001 and 2008. In this series, biochemical recurrence (BR) was defined as a serum PSA 0.2 ng/mL or greater on two consecutive measurements, and none of the patients received any adjuvant therapies until their serum PSA levels reached 0.4 ng/mL or greater. RESULTS The median age and preoperative serum PSA in these 382 patients were 68 years (range, 54–79 years) and 15.9 ng/ml (range, 2.9–65.4 ng/ml), respectively. Pathological examinations demonstrated that pathological stage was pT2, pT3 and pT4 in 195, 151 and 36, respectively, Gleason score was 6, 7 and 8–10 in 40, 148 and 194, respectively, nodal status was pN0 and pN1 in 361 and 21, respectively, and surgical margin status was negative and positive in 201 and 181, respectively. During the observation period (median, 48.0 months), BR occurred in 134 of the 382 patients; however, there was no patient died of cancer progression. The 1-, 3- and 5-year BR-free survival (BRFS) rates were 79.2%, 68.4% and 60.1%, respectively. Among several factors examined, capsular invasion, seminal vesicle invasion and surgical margin status appeared to be independently associated with BRFS on multivariate analysis. Furthermore, there were significant differences in BRFS according to positive numbers of these three independent risk factors; that is, BR occurred in 21 of 140 patients who were negative for all risk factors (15.0%), 69 of 168 positive for a single risk factor (41.1%), and 45 of 74 positive for 2 or 3 risk factors (60.8%). CONCLUSIONS These findings suggest that comparatively favorable cancer control could be achieved by RP as monotherapy for Japanese men with high risk prostate cancer; however, RP alone may not be insufficient in patients with positive for capsular invasion, seminal vesicle invasion and/or surgical margin. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e593 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Junya Furukawa Kobe, Japan More articles by this author Hideaki Miyake Kobe, Japan More articles by this author Masato Fujisawa Kobe, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...