Radical prostatectomy for high-risk prostate cancer: biochemical outcome.
OBJECTIVE
To determine the biochemical outcome following radical prostatectomy alone in patients with high-risk prostate cancer.


METHODS
Between January 2002 and August 2007, 252 patients underwent radical retropubic prostatectomy. Those who received neoadjuvant hormone therapy were excluded from this analysis. Based on pre-operative data, we stratified the patients into low, intermediate, and high-risk groups according to the risk criteria of the National Comprehensive Cancer Network in 2003, respectively. Prostate-specific antigen (PSA) failure was defined as any detectable PSA level higher than 0.2 ng/mL.


RESULTS
The PSA failure-free survival rate for the high-risk group (n = 46) was 64.5% after a median follow-up period of 39 months. Among patients with high-risk disease, none with pathologically organ-confined cancer (n = 19) and a negative surgical margin had PSA failure. The PSA failure-free rate in patients with non organ-confined cancer (n = 27) was 39.5%. Among the pretreatment variables, a positive biopsy core percentage (the number of positive biopsy cores/total biopsy core) >or=30 was a significant independent predictor of extra prostatic extension.


CONCLUSIONS
Radical prostatectomy is feasible in high-risk prostate cancer patients, only if they have a pathologically organ-confined disease.
Kawamorita
Naoki
N
Departments of Urology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan. kawamorita@uro.med.tohoku.ac.jp
Saito
Seiichi
S
Ishidoya
Shigeto
S
Ito
Akihiro
A
Saito
Hideo
H
Kato
Masanori
M
Arai
Yoichi
Y
D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000097:blood; D016016:Proportional Hazards Models; D011467:Prostate / Q000473:pathology* / Q000601:surgery; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology / Q000601:surgery*; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome
D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen