878 Outcomes of Men Undergoing Surgery for Gleason 8-10 Prostate Cancer: A Single Centre Retrospective Study

Abstract

Abstract Aim In this retrospective study, we evaluate patient outcomes for patients with localised Gleason 8-10 prostate cancer opting for radical prostatectomy. Method A list of men with Gleason 8-10 localised prostate cancer on pre-operative prostate biopsy who underwent radical prostatectomy (RP) within our tertiary referral unit between 1st January 2002 and 2nd June 2020 were obtained through departmental operative and histology records. Electronic patient record systems were retrospectively reviewed for demographic information, pre-op PSA, biopsy histology, clinical staging, type of prostatectomy, final histology, post-operative information (PSA, time to biochemical recurrence, time to metastasis, duration of urology follow-up). Results 104 patients with Gleason 8-10 disease underwent RP, with median follow-up period of 65 months. Mean (± SD) age at operation was 64.2 ± 6.1 years. Prostate biopsies revealed Gleason 9 disease in 54.8%, Gleason 8 in 40.4% and Gleason 10 in 4.8%. 28% of RP were performed laparoscopically, and 49% robot-assisted. 27% of patients had T3b status at surgery, and 7% had positive lymph nodes. 57.5% of all patients had positive surgical margins. 7.7% of patients required adjuvant radiotherapy, and 28.8% underwent salvage radiotherapy. 5-year overall survival was 90.9%; 10 year overall survival 77.1%. 5- and 10-year biochemical recurrence-free survival rates were 76.3% and 52.9% respectively; 5 and 10 year metastasis-free survival rates were 87.3% and 70.6% respectively. Conclusions Whilst many men who have radical prostatectomy for Gleason 8-10 prostate cancer develop biochemical recurrence, overall and metastasis-free survival rates are acceptable.