Results of radical prostatectomy in men with clinically localized prostate cancer.
OBJECTIVE
To assess the results of radical prostatectomy in men with early prostate cancer.


METHODS
Retrospective, nonrandomized, multi-institutional pooled analysis.


METHODS
Eight university medical centers in the United States and Europe.


METHODS
A total of 2758 men with stage Tl and T2 prostatic cancer.


METHODS
Disease-specific and metastasis-free survival rates.


RESULTS
Tumor grade was the most important preoperative factor in determining outcome. Disease-specific survival 10 years following surgery and associated 95% confidence intervals were 94% (range, 87%-98%), 80% (range, 74%-85%), and 77% (range, 65%-86%) for those men with grade 1, 2, and 3 tumors, respectively. Metastasis-free survival at 10 years was 87% (range, 78%-92%), 68% (range, 62%-73%), and 52% (range, 38%-64%) for patients with grade 1, 2, and 3 cancers, respectively.


CONCLUSIONS
Radical prostatectomy leads to high 10-year disease-specific survival rates in men with all tumor grades. However, caution is needed in comparing these results with similar studies of alternative treatment strategies, such as watchful waiting, due to the inherent potential biases in uncontrolled trials. Nevertheless, these results offer the best currently available estimates of 10-year outcome of radical prostatectomy in men with clinically localized prostate cancer and may be useful in counseling patients with early malignancy.
Gerber
G S
GS
Section of Urology, Department of Surgery, University of Chicago (III) Pritzker School of Medicine, IL 60637, USA.
Thisted
R A
RA
Scardino
P T
PT
Frohmuller
H G
HG
Schroeder
F H
FH
Paulson
D F
DF
Middleton
A W
AW
Rukstalis
D B
DB
Smith
J A
JA
Schellhammer
P F
PF
Ohori
M
M
Chodak
G W
GW
D005060:Europe; D006801:Humans; D008297:Male; D016016:Proportional Hazards Models; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D016019:Survival Analysis; D014481:United States