MP05-17 IDENTIFICATION OF TREATABLE HIGH RISK PROSTATE CANCER ONLY BY RADICAL PROSTATECTOMY-WHO ARE GOOD CANDIDATES FOR RADICAL PROSTATECTOMY IN HIGH RISK PROSTATE CANCER-

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy I1 Apr 2018MP05-17 IDENTIFICATION OF TREATABLE HIGH RISK PROSTATE CANCER ONLY BY RADICAL PROSTATECTOMY-WHO ARE GOOD CANDIDATES FOR RADICAL PROSTATECTOMY IN HIGH RISK PROSTATE CANCER- Kazuhiro Nagao, Junichi Mori, Kosuke Shimizu, Yoshihisa Kawai, Ryo Inoue, Yoshiaki Yamamoto, Hiroaki Matsumoto, and Hideyasu Matsuyama Kazuhiro NagaoKazuhiro Nagao More articles by this author , Junichi MoriJunichi Mori More articles by this author , Kosuke ShimizuKosuke Shimizu More articles by this author , Yoshihisa KawaiYoshihisa Kawai More articles by this author , Ryo InoueRyo Inoue More articles by this author , Yoshiaki YamamotoYoshiaki Yamamoto More articles by this author , Hiroaki MatsumotoHiroaki Matsumoto More articles by this author , and Hideyasu MatsuyamaHideyasu Matsuyama More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.188AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES According to the EAU guideline, not all patients with high risk prostate cancer (PCa) have a uniformly poor prognosis after radical prostatectomy (RP), but there is no consensus regarding who could get most benefit by RP in the patients with high-risk PCa. We aimed to identify the treatable high-risk PCa only by RP. METHODS We retrospectively reviewed 315 patients with D′Amico high-risk PCa treated by RP without neoadjuvant or adjuvant therapy in the institutions belonging to Yamaguchi Uro-Oncology Group between 2009 and 2013. Primary end-point was biochemical progression free survival (bPFS) after RP. Risk factors for biochemical progression were extracted using the Cox proportional hazard model. We stratified the high risk PCa into 3 subgroups in bPFS after RP by using the risk factors. RESULTS At a median follow-up of 49.9 months (1.9-1335), biochemical progression was observed in 63 cases (20.5%). bPFS at 2 and 5 years after RP were 89.4% and 70.0%, respectively. Univariate analysis showed prostate specific antigen (PSA) at diagnosis (≥15ng/ml), PSA density (≥0.5), Gleason score (GS) at biopsy (≥8) and % positive core (≥30%) could be risk factors for biochemical progression. On multivariate analysis, GS at biopsy (HR: 1.92, p<0.05) and % positive core (HR: 2.85, p<0.005) could be independent predictors of biochemical progression. Patients were stratified into favorable- (0 risk factor; 117 patients), intermediate- (1 risk factor; 127 patients), and poor-risk (2 risk factors; 57 patients) groups based on the number of predictive factors. On Cox proportional hazard model, this risk classification model could significantly predict biochemical progression after RP (low-risk; HR: 1.0, intermediate-risk; HR: 2.26, high-risk; HR: 5.03, p<0.0001). CONCLUSIONS Risk of biochemical progression of high risk PCa after RP could be stratified by GS at biopsy (≥8) and % positive core (≥30%). Our stratification model may aid in selecting treatment modality for D′Amico high risk PCa. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e49-e50 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Kazuhiro Nagao More articles by this author Junichi Mori More articles by this author Kosuke Shimizu More articles by this author Yoshihisa Kawai More articles by this author Ryo Inoue More articles by this author Yoshiaki Yamamoto More articles by this author Hiroaki Matsumoto More articles by this author Hideyasu Matsuyama More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...