Treatment results of radical prostatectomy for localized prostate cancer--biochemical failure analyzed from pathological findings at surgery

Abstract

Recurrence is not rare after radical prostatectomy for localized prostate cancer. The treatment results of radical prostatectomy for localized prostate cancer was evaluated in this retrospective study. A total of 36 patients with localized prostate cancer (clinical stage: A, B) were treated with radical prostatectomy. Kaplan-Meier product limit method analyzed from biochemical failure was used to study the treatment results of radical prostatectomy, and Cox's proportional hazards model was used to analyze the influence of pathological findings at surgery on biochemical failure. Of all 36 patients, 24 (67%) had pT3 (N0-2) disease, and these patients received adjuvant hormonal therapy after surgery. Overall freedom from biochemical failure at 5 years after surgery was 53% (pT1-2N0; 83%, pT3N0-2; 40%). No significant difference was seen in the freedom from biochemical failure between patients grouped by pathological classification (p = 0.106), tumor grade (p = 0.476), proximal and distal margin involvement (p = 0.095) and regional lymph node metastasis (p = 0.482), but a significant difference was seen between patients grouped by capsule involvement (freedom from biochemical failure at 5 years in cases with positive capsule: 30%, p = 0.023) and seminal vesicle involvement (freedom from biochemical failure at 5 years in cases with positive seminal vesicles: 26%, p = 0.014). Cox's proportional hazards model, on the other hand, showed only that seminal vesicle involvement significantly influenced on biochemical failure (p = 0.031). We confirmed a high likelihood of biochemical failure and presumably less favorable prognosis in patients with seminal vesicle involvement. These results indicated that candidates for surgery should be selected pathologically by excluding those with seminal vesicle involvement in the preoperative evaluation.