Abstract
Oncologic outcomes of radical prostatectomy in 106 patients with clinically locally advanced prostate cancer were demonstrated. The mean follow-up was 50.6 (12-129) months. 5-year recurrence-free survival was 47.7 %, 5-year cancer-specific and overall survival - 85.8 %. Patients were devided into three different risk groups: low risk patients had PSA level <20 ng/ml, biopsy Gleason score ≤6 and absence of the seminal vesicle invasion of cancer; intermediate risk was noted when the patient had only one of poor prognostic factors (PSA ≥20 ng/ml or biopsy Gleason score≥7 or presence of cancer invasion to the seminal vesicle) and high risk patients had 2 or 3 poor prognostic factors. For patients of low, intermediate and high risk the biochemical reccurence rates were 14.3 %, 37.1 % and 70.2 %, respectively (p=0.002). The patients of intermediate and high risk had clinically significant higher risk of biochemical reccurence than those of low risk with odds ratio 3.0 and 8.5, respectively. Such grouping may help in guiding the individualized treatment for these patients.
Highlights
Advanced prostate cancer (PCa) is defined as a tumor that has extended beyond the prostatic capsule, including invasion of the periprostatic fat, bladder neck or seminal vesicles, but without regional or distant metastases
In the absence of randomized clinical trials comparing the effectiveness of radical prostatectomy (RPE), radiotherapy (RT), androgen deprivation therapy (ADT), or combination of these methods, it is difficult to determine the optimal treatment strategy for these patients
Material and methods We identified and treated with RPE 106 patients with clinically locally advanced PCa between August 2002 and June 2015 at State Institution ‘Institute of Urology of National Academy of Medical Sciences of Ukraine’
Summary
Advanced prostate cancer (PCa) is defined as a tumor that has extended beyond the prostatic capsule, including invasion of the periprostatic fat, bladder neck or seminal vesicles, but without regional or distant metastases. In 2013 in Ukraine, the percentage of locally advanced disease in the prostate cancer incidence was 23.1 % compared with 31.1 % in 2003 [3, 4]. RPE with an extended pelvic lymphadenectomy is a proper treatment option of patient with locally advanced PCa accepted by international guidelines [5]. RPE benefits are to achieve the maximal tumor reduction and following pathological examination that allows to select patients who need adjuvant treatment. Prospective studies in this area allow only overall treatment strategies of this group of patients [6, 7]
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