MP40-18 LONG-TERM ONCOLOGICAL OUTCOMES FOLLOWING RADICAL PROSTATECTOMY FOR CLINICAL T1A AND T1B PROSTATE CANCER

Abstract

INTRODUCTION AND OBJECTIVES: Prostate cancer (PCa) is incidentally found in 4e16% of patients surgically treated for benign prostatic hyperplasia. It is staged as clinical T1a or T1b based on the percentage of tumor in the specimen: 0.2 ng/mL and/or biopsy-proven local recurrence. Metastasis was determined by imaging. Cause of death was obtained from death certificates. RESULTS: A total of 86 (34%) and 166 (66%) men had cT1a and cT1b PCa, respectively. Compared to cT1b, cT1a men had less positive surgical margins and lower pathological Gleason score (P 0.05). A total of 12 (14%) T1a and 45 (27%) T1b men developed disease recurrence over a median follow-up of 14.8 years. No cT1a and 9 (5%) cT1b men developed metastasis. No cT1a and 6 (4%) cT1b died of PCa. Compared to patients with cT1b tumors, cT1a patients had longer recurrence-free and metastasis-free survival (both P < 0.05) and a trend toward better disease-specific survival (P 1⁄4 0.078; Figure). CONCLUSIONS: cT1a PCa is associated with low stage and low grade disease. Although both cT1a and cT1b have very favorable prognoses after RP, a small but not negligible percentage of cT1b men will develop systemic progression and experience cancer-specific mortality, compared to no progression or PCa deaths in the T1a group. Our findings support active treatment for selected T1b PCa cases. Source of Funding: None