title: Long-term outcomes of open radical retropubic prostatectomy for clinically localized prostate cancer in the prostate-specific antigen era.
abstract: OBJECTIVE
  To determine long-term oncological outcomes and complication rates for patients with clinically organ confined prostate adenocarcinoma (PCa) treated with open radical retropubic prostatectomy and pelvic lymph node dissection (RRP/PLND) in the prostate-specific antigen (PSA) era.
  
  
  METHODS
  Outcomes data were obtained from a prospectively maintained prostate cancer database. Patients with cT1/cT2 PCa undergoing RRP/PLND without neoadjuvant therapy between July 1988 and June 2008 were included. Kaplan-Meier and Cox proportional regression models were used to evaluate factors influencing biochemical recurrence, clinical recurrence, and overall survival (OS).
  
  
  RESULTS
  A total of 2487 patients met inclusion criteria, and median follow-up was 7.2 years (range 1-21 years). Of the patients, 49.7% were low risk, 33.2% intermediate risk, and 16.1% high risk by D'Amico criteria, and 6% were LN+. The 10-year biochemical recurrence-free survival (BCRFS) for low-, intermediate-, and high-risk patients was 92%, 83%, and 76%, respectively (P < .001), and 10 year OS was 91%, 83%, and 74%, respectively (P < .001). BCRFS at 10 years was 76% and 88% for patients with positive and negative margins, respectively (P < .001). Of the 2487 patients, 11% developed BCR, and 3.7% experienced CR, with 9 local recurrences. The overall complication rate was 2.3%, and the cancer specific mortality rate was 2%.
  
  
  CONCLUSIONS
  D'Amico risk group, margin status, and LN status are significantly correlated with outcomes in patients undergoing RRP/PLND for clinically localized PCa. Local recurrence and death from prostate cancer are rare in patients undergoing open RRP/PLND for clinically organ confined disease in the PSA era.
authors.affiliation: USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California 90033-9178, USA. rdorin@usc.edu
authors.forename: Ryan P
authors.initials: RP
authors.lastname: Dorin
authors.forename: Siamak
authors.initials: S
authors.lastname: Daneshmand
authors.forename: Mark A
authors.initials: MA
authors.lastname: Lassoff
authors.forename: Jie
authors.initials: J
authors.lastname: Cai
authors.forename: Donald G
authors.initials: DG
authors.lastname: Skinner
authors.forename: Gary
authors.initials: G
authors.lastname: Lieskovsky
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery*; D018572:Disease-Free Survival; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D018570:Risk Assessment; D016896:Treatment Outcome
chemical_list: D017430:Prostate-Specific Antigen