title: Impact of radical prostatectomy in the management of clinically localized disease.
abstract: The cancer specific death rate following radical prostatectomy in patients with organ confined and specimen confined disease was 10% at 13.5 years, less than the noncancer death rate of 20% for patients in these disease extent categories. The median age of all patients in these categories was 65 years. Cancer remains the dominate cause of death in patients with margin-positive disease, being 40% at 13.5 years. Disease detected by prostate specific antigen (PSA) rather than digital rectal examination appears to be of smaller volume and to have a higher probability of negative margins. Data argue that early detection of PSA will shift patients to a more favorable disease category at surgical intervention. Disease recurrence or persistence by PSA detection seems to precede clinical detection of disease by 3 to 5 years. Disease recurrence by PSA detection does not predict survival outcome, probably does not differentiate between local and distant microscopic recurrence, and is not predictive of biological aggressiveness.
authors.affiliation: Division of Urologic Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: D F
authors.initials: DF
authors.lastname: Paulson
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010808:Physical Examination; D011182:Postoperative Care; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology / Q000601:surgery*; D018714:Radiotherapy, Adjuvant; D012007:Rectum; D015996:Survival Rate
chemical_list: D017430:Prostate-Specific Antigen