MP56-02 HEAD TO HEAD COMPARISON OF CONDITIONAL ONCOLOGICAL OUTCOMES AFTER RADICAL PROSTATECTOMY IN PATIENTS WITH INTERMEDIATE AND HIGH RISK PROSTATE CANCER

Abstract

You have accessJournal of UrologyProstate Cancer: Localized III1 Apr 2015MP56-02 HEAD TO HEAD COMPARISON OF CONDITIONAL ONCOLOGICAL OUTCOMES AFTER RADICAL PROSTATECTOMY IN PATIENTS WITH INTERMEDIATE AND HIGH RISK PROSTATE CANCER Marco Bianchi, Nicola Fossati, Giorgio Gandaglia, Rayan Matloob, Firas Abdollah, Umberto Capitanio, Federico Dehò, Vincenzo Scattoni, Shahrokh F. Shariat, Pierre Karakiewicz, Francesco Montorsi, and Alberto Briganti Marco BianchiMarco Bianchi More articles by this author , Nicola FossatiNicola Fossati More articles by this author , Giorgio GandagliaGiorgio Gandaglia More articles by this author , Rayan MatloobRayan Matloob More articles by this author , Firas AbdollahFiras Abdollah More articles by this author , Umberto CapitanioUmberto Capitanio More articles by this author , Federico DehòFederico Dehò More articles by this author , Vincenzo ScattoniVincenzo Scattoni More articles by this author , Shahrokh F. ShariatShahrokh F. Shariat More articles by this author , Pierre KarakiewiczPierre Karakiewicz More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , and Alberto BrigantiAlberto Briganti More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2066AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Prostate cancer (PCa) patient prognosis may vary according to the time elapsed from treatment without recurrence. This effect is known as conditional survival. We tested whether conditional survival may obliterate the differences in oncological outcomes after radical prostatectomy (RP) in men with aggressive PCa METHODS We evaluated data of 4,300 patients treated with RP between 1990 and 2013 for intermediate (n=2780; 64.7%) and high risk PCa (n=1520; 35.3%). First, we estimated biochemical recurrence (BCR), metastasis free survival (MFS) and cancer specific survival (CSS) rates using the Kaplan Meier method. Second, conditional BCR, MFS and CSS rates were derived according to risk group at diagnosis. For any of the mentioned outcomes, conditional survival rates of patients with intermediate and high risk PCa were compared at any time point. RESULTS Median follow up was 61 months. The baseline 5 and 10-year BCR free survival, MFS and CSS rates were 86.6 vs. 74.7% and 72.5 vs. 56.3%, 98.1% vs. 95.9% and 86.9 vs. 79.6%, 99.4 vs. 97.8% and 93.6 vs. 84.8% for intermediate vs. high risk patients (all p <0.001). Among men who survived without BCR for ≥1, ≥3, ≥5 years after RP, the probability of surviving additional 5 years without BCR was 86 vs. 73.5%, 87.7 vs. 75% and 87 vs. 77.4% for intermediate vs. high risk patients, respectively (all p<0.001). The impact of risk group on BCR disappeared after 8 years of BCR free survivorship (85.5 vs. 82.8% for intermediate and high risk; p=0.07). In patients who experienced BCR, the baseline 5 years MFS rates were 87.9 vs. 51.4% for intermediate and high-risk patients (p<0.001). Amongst those who survived without metastasis for ≥1, ≥2 and ≥3 years after BCR, the probability of surviving additional 5 years without metastasis were 95.7 vs. 66.9%, 95.0 vs. 73.0%, and 96.0 vs. 79.6% for intermediate and high risk patients (all p≤0.005). The impact of risk group on MFS disappeared after 5 years of MFS after BCR (96.0 vs. 93.7% for intermediate and high risk; p=0.3). Finally, in those patients who developed metastasis, there was no effect of risk group on CSS (p=0.2) CONCLUSIONS Patients with high risk PCa may obtain long-term cancer control comparable to those with intermediate risk disease only given a 5-year lack of disease progression. However, when metastases occur, the effect of cancer characteristics at diagnosis on patient survival is obliterated. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e681 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Marco Bianchi More articles by this author Nicola Fossati More articles by this author Giorgio Gandaglia More articles by this author Rayan Matloob More articles by this author Firas Abdollah More articles by this author Umberto Capitanio More articles by this author Federico Dehò More articles by this author Vincenzo Scattoni More articles by this author Shahrokh F. Shariat More articles by this author Pierre Karakiewicz More articles by this author Francesco Montorsi More articles by this author Alberto Briganti More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...