title: 10-Year Mortality After Radical Prostatectomy for Localized Prostate Cancer in the Prostate-specific Antigen Screening Era.
abstract: OBJECTIVE
  To provide insight into the impact of radical prostatectomy (RP) on prostate cancer-specific mortality (PCSM) in a primarily prostate-specific antigen screen-detected cohort of men with localized prostate cancer (PCa).
  
  
  METHODS
  Between 2000 and 2013, 1864 men consented to participate in a prospective longitudinal outcomes study after RP for localized PCa by a single surgeon. Men lost to follow-up were queried to the National Death Index to acquire mortality data.
  
  
  RESULTS
  From our cohort of 1864 men (median age 59 years, median preoperative prostate-specific antigen 5.0, median follow-up 9.1 years), Kaplan-Meier analysis demonstrated 10-year all-cause mortality and PCSM of 4.6% and 1.4%, respectively. Ten-year PCSM for low, intermediate, and high D'Amico risk were 0.9%, 1.0%, and 7.4%, respectively (P <.001). For men with postoperative Gleason score 4-6, 7, and 8-10, 10-year PCSM was 0.8%, 1.0%, and 11.5%, respectively (P <.001). Men with pT2, pT3a, and pT3b disease had 10-year PCSM of 0.7%, 2.6%, and 9.5%, respectively (P <.001). Pathologic stage and grade were the only significant independent predictor of PCSM at 10 years (P = .002 and P = .025, respectively).
  
  
  CONCLUSIONS
  In our series with up to 13 years of follow-up from the National Death Index, 10-year PCSM after RP for clinically localized PCa was very low and strongly predicted by pathologic stage and grade. Death unrelated to PCa was a rare event, suggesting that we are identifying candidates for RP who are likely to live long enough to benefit from surgical intervention.
authors.affiliation: School of Medicine, New York University Langone Medical Center, New York, NY.
authors.forename: Neil
authors.initials: N
authors.lastname: Mendhiratta
authors.affiliation: School of Medicine, New York University Langone Medical Center, New York, NY.
authors.forename: Ted
authors.initials: T
authors.lastname: Lee
authors.affiliation: Department of Urology, New York University Langone Medical Center, New York, NY.
authors.forename: Vinay
authors.initials: V
authors.lastname: Prabhu
authors.affiliation: Department of Urology, New York University Langone Medical Center, New York, NY.
authors.forename: Elton
authors.initials: E
authors.lastname: Llukani
authors.affiliation: Department of Urology, New York University Langone Medical Center, New York, NY. Electronic address: Herbert.lepor@nyumc.org.
authors.forename: Herbert
authors.initials: H
authors.lastname: Lepor
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood; D002423:Cause of Death / Q000639:trends; D055088:Early Detection of Cancer; D005544:Forecasting; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000401:mortality* / Q000601:surgery; D015996:Survival Rate / Q000639:trends
chemical_list: D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen