Oncological outcomes following radical prostatectomy for patients with pT4 prostate cancer
Int. braz. j. urol
;
42(6): 1091-1098, Nov.-Dec. 2016. tab, graf
Artigo
em Inglês
| LILACS
| ID: biblio-828928
ABSTRACT
ABSTRACT Objectives:
Radical prostatectomy (RP) for locally advanced prostate cancer may reduce the risk of metastasis and cancer-specific death. Herein, we evaluated the outcomes for patients with pT4 disease treated with RP. Materials andmethods:
Among 19,800 men treated with RP at Mayo Clinic from 1987 to 2010, 87 were found to have pT4 tumors. Biochemical recurrence (BCR)-free survival, systemic progression (SP) free survival and overall survival (OS) were estimated using the Kaplan-Meier method and compared with the log-rank test. Cox proportional hazards regression models were used to assess the association of clinic-pathological features with outcome.Results:
Median follow-up was 9.8 years (IQR 3.6, 13.4). Of the 87 patients, 50 (57.5%) were diagnosed with BCR, 30 (34.5%) developed SP, and 38 (43.7%) died, with 11 (12.6%) dying of prostate cancer. Adjuvant androgen deprivation therapy was administered to 77 men, while 32 received adjuvant external beam radiation therapy. Ten-year BCR-free survival, SP-free survival, and OS was 37%, 64%, and 70% respectively. On multivariate analysis, the presence of positive lymph nodes was marginally significantly associated with patients' risk of BCR (HR 1.94; p=0.05), while both positive lymph nodes (HR 2.96; p=0.02) and high pathologic Gleason score (HR 1.95; p=0.03) were associated with SP.Conclusions:
Patients with pT4 disease may experience long-term survival following RP, and as such, when technically feasible, surgical resection should be considered in the multimodal treatment approach to these men.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Prostatectomia
/
Neoplasias da Próstata
/
Recidiva Local de Neoplasia
Tipo de estudo:
Estudo prognóstico
Limite:
Idoso
/
Humanos
/
Masculino
País/Região como assunto:
América do Norte
Idioma:
Inglês
Revista:
Int. braz. j. urol
Assunto da revista:
Urologia
Ano de publicação:
2016
Tipo de documento:
Artigo
País de afiliação:
Estados Unidos
Instituição/País de afiliação:
Mayo Clinic/US
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