Outcomes of radical prostatectomy in clinically locally advanced N0M0 prostate cancer.
BACKGROUND
Radical prostatectomy (RP) in patients with locally advanced (cT3) prostate cancer (PCa) is considered an optional therapy.


OBJECTIVE
To evaluate outcomes of surgery for cT3 disease and to compare results with those of patients treated for cT1-T2 PCa.


METHODS
Data of 74 consecutive patients with cT3 N0M0 PCa who underwent RP were compared to those of 425 consecutive unselected patients who underwent surgery for cT1-T2 N0M0 disease.


RESULTS
cT3: The pathological report showed a pathological downstaging in 16.3% of cases. Continence rate was 65.5%, potency rate was 38.8%, 5-year PSA-free survival was 61.9%, 5-year cancer-specific survival was 95.2%. cT1-T2: The pathological report showed a clinical downstaging in 39.1%. Continence rate was 70.8%, potency rate was 56.2%, 5-year PSA-free survival was 67.4%, 5-year cancer-specific survival was 96.0%.


CONCLUSIONS
cT3 PCa presents challenges for the uro-oncologist since standard treatment is still under debate. RP in well-informed patients is a procedure with acceptable morbidity and should be at least a first part of a multimodality approach.
Mearini
Luigi
L
Urology Department, University of Perugia, Perugia, Italy. luigi.mearini@tin.it
Zucchi
Alessandro
A
Costantini
Elisabetta
E
Bini
Vittorio
V
Nunzi
Elisabetta
E
Porena
Massimo
M
D000368:Aged; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D006801:Humans; D007558:Italy; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D018579:Patient Selection; D016016:Proportional Hazards Models; D011468:Prostatectomy / Q000009:adverse effects / Q000401:mortality; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D018714:Radiotherapy, Adjuvant; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome