title: Radical prostatectomy outcome when performed with PSA above 20 ng/ml.
abstract: Many centres currently do not offer radical prostatectomy (RP) to men with high-risk localised prostate cancer due to concerns regarding poor outcome, despite evidence to the contrary. We identified 18 men undergoing RP with serum PSA >20 ng/ml (high-risk by National Comprehensive Cancer Network definition) and minimum follow-up of 12 years (mean 13.5). Mean preoperative PSA was 37.0 ng/ml (Range 21.1-94.0). Prostatectomy pathology reported extracapsular disease in 16 (88.9%), positive surgical margins in 15 (83%) and positive pelvic lymph nodes in 5 (27.8%). Overall and cancer-specific survival at 5 and 10-years was 83.3%, 88.2%, 72% and 76.5% respectively. With complete follow-up 11 (61.1%) are alive, and 5 (27.8%) avoided any adjuvant therapy. Complete continence (defined as no involuntary urine leakage and no use of pads) was achieved in 60%, with partial continence in the remainder. We conclude that surgery for this aggressive variant of localised prostate cancer can result in satisfactory outcome.
authors.affiliation: Department of Urology, St Vincent's University Hospital, Elm Park, Dublin 4. stephensconnolly@gmail.com
authors.forename: S S
authors.initials: SS
authors.lastname: Connolly
authors.forename: S F
authors.initials: SF
authors.lastname: Oon
authors.forename: C
authors.initials: C
authors.lastname: Carroll
authors.forename: S
authors.initials: S
authors.lastname: Kinsella
authors.forename: M F
authors.initials: MF
authors.lastname: O'Brien
authors.forename: D W
authors.initials: DW
authors.lastname: Mulvin
authors.forename: D M
authors.initials: DM
authors.lastname: Quinlan
mesh_terms: D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate
chemical_list: D017430:Prostate-Specific Antigen