339 LONG TERM OUTCOMES OF RADICAL PROSTATECTOMY FOR CLINICALLY ADVANCED (CT3) PROSTATE CANCER

Abstract

You have accessJournal of UrologyProstate Cancer: Epidemiology and Natural History1 Apr 2011339 LONG TERM OUTCOMES OF RADICAL PROSTATECTOMY FOR CLINICALLY ADVANCED (CT3) PROSTATE CANCER Christopher Mitchell, Eric Umbreit, Rachel Carlson, Laureano Rangel, and R. Jeffrey Karnes Christopher MitchellChristopher Mitchell Rochester, MN More articles by this author , Eric UmbreitEric Umbreit Rochester, MN More articles by this author , Rachel CarlsonRachel Carlson Rochester, MN More articles by this author , Laureano RangelLaureano Rangel Rochester, MN More articles by this author , and R. Jeffrey KarnesR. Jeffrey Karnes Rochester, MN More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.423AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We update the long term outcomes of patients with locally advanced (cT3) prostate cancer compared to men with localized disease (cT2) treated with radical prostatectomy (RP). METHODS We identified 7883 men who underwent RP in the early prostate-specific antigen (PSA) era (1987–1997). Of these 4812 (61%) with cT2 and 843 (15%) with cT3 disease were analyzed for progression free, cancer specific, and overall survival by Kaplan-Meier plots. RESULTS The median follow-up was 14.3 years (0.1–23.5). Clinical over-staging of cT3 disease occurred in 26% (223/843) with subsequent down-staging to pT2 at RP. Men with cT3 were more likely than men with cT2 disease to have adverse features including pathologic Gleason score °́Y7 (59% vs 39%, p<0.0001), aneuploid tumor (14% vs 6%, p<0.0001), lymph node metastasis (27% vs 7%, p<0.0001), positive surgical margin (56% vs 38%, p<0.0001), larger tumor volumes (5.2 vs 2.6 cm3, p<0.0001) and require post-operative hormonal or radiotherapy (42% vs 76%, p<0.0001). Men with cT3 were twice as likely to have disease progression (32% vs 16%) and die of prostate cancer (15% vs 6%) than men with cT2 disease. Cancer specific survival at 20 years follow-up (90% vs 80%, p<0.0001) was higher for cT2 than cT3 disease (figure 1). CONCLUSIONS cT3 prostate cancer is overstaged in the PSA era, however cT3 stills predicts adverse pathologic features at RP. While inferior to those of men with cT2 disease, oncologic outcomes for men with cT3 disease remain high with long term follow-up. RP as part of a multimodal treatment strategy for patients with cT3 disease offers durable cancer control and survival rates 20 years following RP. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e136-e137 Peer Review Report Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Christopher Mitchell Rochester, MN More articles by this author Eric Umbreit Rochester, MN More articles by this author Rachel Carlson Rochester, MN More articles by this author Laureano Rangel Rochester, MN More articles by this author R. Jeffrey Karnes Rochester, MN More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...