title: Radical prostatectomy as radical cure of prostate cancer in a high-risk group: A single-institution experience.
abstract: This study aimed to evaluate the possibility of performing radical prostatectomy (RP) alone to achieve radical cure of prostate cancer in a high-risk group. Between August 1998 and December 2008, 436 Japanese patients underwent antegrade RP following the exclusion of 139 patients. According to the D'Amico criteria, the low-, intermediate- and high-risk groups comprised 63, 122 and 112 patients, respectively. Twenty-five patients who were classified into the high-risk group based only on T2c stage, were evaluated as a separate intermediate/high-risk group. Results of the multivariate analysis revealed that of the preoperative characteristics only a biopsy Gleason score was a significant predictor in patients with and without PSA failure (P=0.017). After a median follow-up period of 60 months, the PSA failure-free rates in the low-, intermediate-, high- and intermediate/high-risk groups were 96.5, 92.2, 76.8 and 95.0%, respectively. No statistically significant difference was detected in the high- and intermediate/high-risk groups (P=0.064). Thus, patients classified into the high-risk group based on cT2 stage only, are considered to be potentially eligible for radical treatment by surgery alone, and should not be evaluated as high-risk patients.
authors.affiliation: Departments of Urology, National Kyushu Cancer Center, Fukuoka, Japan.
authors.forename: Nobuki
authors.initials: N
authors.lastname: Furubayashi
authors.affiliation: Departments of Urology, National Kyushu Cancer Center, Fukuoka, Japan.
authors.forename: Motonobu
authors.initials: M
authors.lastname: Nakamura
authors.affiliation: Departments of Urology, National Kyushu Cancer Center, Fukuoka, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Hishikawa
authors.affiliation: Departments of Urology, National Kyushu Cancer Center, Fukuoka, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Fukuda
authors.affiliation: Departments of Urology, National Kyushu Cancer Center, Fukuoka, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Matsumoto
authors.affiliation: Pathology, National Kyushu Cancer Center, Fukuoka, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Nishiyama
authors.affiliation: Institute for Clinical Research, National Kyushu Cancer Center, Fukuoka, Japan.
authors.forename: Takeharu
authors.initials: T
authors.lastname: Yamanaka
authors.affiliation: Departments of Urology, National Kyushu Cancer Center, Fukuoka, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Hasegawa
keywords: D’Amico classification; high-risk group; prostate cancer; prostate-specific antigen failure; radical prostatectomy