Results of radical prostatectomy and adjuvant therapy in the management of locally advanced, clinical stage TC, prostate cancer.
Fifty-seven patients with locally advanced, clinical stage TC, adenocarcinoma of the prostate underwent treatment consisting of surgery, external beam radiation therapy and, in selected patients, early hormonal ablation and/or systemic chemotherapy. Surgical morbidity from radical retropubic prostatectomy and limited pelvic lymph node dissection was acceptable with an early complication rate of 11%. Followup ranged from 3.5 to 19.9 years (median 5.4 years). Actuarial 5 and 7.5 years survival rates for all patients was 91.2% and 77.6%, respectively. Of the 57 study patients 19 (33%) were alive with no evidence of disease, including a prostate specific antigen (PSA) less than 0.4 ng/ml at all times during follow-up. The estimated 5 year probability of clinical recurrence was 18.6% and the 5 year probability of clinical and PSA recurrence (> 0.4 ng/ml) was 54.5%. Local recurrence occurred in only 3 patients. This included 2 (4%) patients who received adjuvant radiotherapy. Our results suggest that patients with locally advanced prostate cancer can be successfully treated with low morbidity using a combination of radical prostatectomy and planned adjuvant radiotherapy.
Yamada
A H
AH
Department of Urology, University of Southern California School of Medicine, Los Angeles 90033.
Lieskovsky
G
G
Petrovich
Z
Z
Chen
S C
SC
Groshen
S
S
Skinner
D G
DG
D000230:Adenocarcinoma / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D000368:Aged; D003131:Combined Modality Therapy; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D009919:Orchiectomy; D011183:Postoperative Complications / Q000209:etiology; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods; D011471:Prostatic Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D015996:Survival Rate