title: 25-year prostate cancer control and survival outcomes: a 40-year radical prostatectomy single institution series.
abstract: OBJECTIVE
  We report on 25-year cancer control and survival outcomes after radical prostatectomy in a single center series of patients treated during a 40-year period.
  
  
  METHODS
  Between 1954 and 1994, 787 consecutive patients underwent radical prostatectomy at Virginia Mason Medical Center in Seattle, Washington. Kaplan-Meier 25-year probabilities of prostate cancer specific, overall, prostate specific antigen progression-free, local and distant progression-free survival were determined. Multivariate Cox regression models addressed prostate cancer specific mortality.
  
  
  RESULTS
  Prostate cancer specific survival, overall survival, prostate specific antigen progression-free survival, local and distant progression-free survival ranged from 99.0% to 81.5%, 93.5% to 19.3%, 84.8% to 54.5%, 95.3% to 87.8% and 95.9% to 78.2%, respectively. In univariate analyses pathological stage, surgical margin status, pathological Gleason sum, delivery of hormonal therapy and radiotherapy represented statistically significant predictors of prostate cancer specific mortality (all p < or =0.001). In multivariate analyses only Gleason sum (p = 0.03) and delivery of hormonal therapy (p < 0.001) remained significant.
  
  
  CONCLUSIONS
  This is one of the most mature radical prostatectomy series. It demonstrates that long-term biochemical cancer control outcomes after radical prostatectomy might be suboptimal. However, local and distant control outcomes are excellent, and cancer specific mortality is minimal even 25 years after surgery.
authors.affiliation: Department of Urology, Virginia Mason Medical Center, Seattle, Washington 98101, USA. Christopher.Porter@vmmc.org
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Porter
authors.forename: Koichi
authors.initials: K
authors.lastname: Kodama
authors.forename: Robert P
authors.initials: RP
authors.lastname: Gibbons
authors.forename: Roy
authors.initials: R
authors.lastname: Correa
authors.forename: Felix K-H
authors.initials: FK
authors.lastname: Chun
authors.forename: Paul
authors.initials: P
authors.lastname: Perrotte
authors.forename: Pierre I
authors.initials: PI
authors.lastname: Karakiewicz
mesh_terms: D000328:Adult; D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000401:mortality* / Q000601:surgery*; D015996:Survival Rate; D013997:Time Factors