title: Outcome of antegrade radical prostatectomy with intended wide resection in prostate cancer patients with a preoperative serum PSA level >100 ng/ml.
abstract: OBJECTIVE
  It was the aim of this study to assess the outcome of prostate cancer patients with preoperative prostate-specific antigen (PSA) levels ≥100 ng/ml who were treated with antegrade radical prostatectomy with intended wide resection (aRP).
  
  
  METHODS
  Eighteen patients who underwent aRP had an initial PSA level ≥100 ng/ml. Overall survival, disease-specific survival and biochemical progression-free survival (bPFS) rates were determined, and predictors of treatment outcome were examined.
  
  
  RESULTS
  The median serum PSA level was 159.5 ng/ml. All patients but one had received neoadjuvant androgen deprivation therapy (ADT), while only 2 patients received adjuvant ADT. Five patients were classified as stage pT2, 6 as pT3a, 6 as pT3b and 1 as pT4. Four patients had locoregional lymph node metastases. Twelve patients developed PSA failure. Eight of them received salvage ADT. The estimated 10-year bPFS rate was 25.0% and the overall survival and disease-specific survival rates were 92.9 and 100%, respectively, at a median follow-up of 6 years. Multivariate analysis revealed only the clinical stage to be predictive of bPFS based on preoperative variables. On the other hand, surgical margin status, extracapsular extension and organ-confined disease were identified as being significant postoperative predictors.
  
  
  CONCLUSIONS
  This study showed a comparatively satisfactory outcome for clinically non-metastatic prostate cancer with PSA levels ≥100 ng/ml treated by aRP.
authors.affiliation: Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan. shinurakami@ybb.ne.jp
authors.forename: Shinji
authors.initials: S
authors.lastname: Urakami
authors.forename: Junji
authors.initials: J
authors.lastname: Yonese
authors.forename: Shinya
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yuasa
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kitsukawa
authors.forename: Noboru
authors.initials: N
authors.lastname: Numao
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Kubo
authors.forename: Masaya
authors.initials: M
authors.lastname: Ito
authors.forename: Gen
authors.initials: G
authors.lastname: Sukegawa
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Yasuda
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ishikawa
authors.forename: Iwao
authors.initials: I
authors.lastname: Fukui
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D006801:Humans; D007564:Japan; D008297:Male; D008495:Medical Oncology / Q000379:methods; D008875:Middle Aged; D015999:Multivariate Analysis; D020360:Neoadjuvant Therapy / Q000379:methods; D017430:Prostate-Specific Antigen / Q000096:biosynthesis*; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D017430:Prostate-Specific Antigen