title: Outcome of radical prostatectomy as primary treatment for high-risk prostate cancer patients.
abstract: BACKGROUND
  Recently, there has been considerable interest in the role of radical prostatectomy (RP) in men with high-risk prostate cancer.
  
  
  OBJECTIVE
  The objective of our study is to report the outcome of upfront RP in our patients with high-risk prostate cancer (Stage ≥ cT2c, a pre-operative serum prostate specific antigen >20 ng/ml or a biopsy Gleason score [GS] 8-10).
  
  
  METHODS
  From 1996 to 2010, 208 patients of prostate cancer (high risk category D'Amico's criteria) underwent open RP with bilateral pelvic lymphadenectomy.
  
  
  METHODS
  The data was statistically analyzed using Kaplan Meier method and log rank test to calculate progression free, metastasis free survival (MFS) and cancer specific survival (CSS). Furthermore multivariate analysis (MVA) was carried out using SPSS 14 software. (IBM company).
  
  
  RESULTS
  At 7 and 10 years, prostate cancer-specific survival (PCSS) was found to be 79.7% and 65%, respectively, biochemical recurrence free survival (BRFS) was 42.4% and 36.7%, respectively and the MFS was 71.1% and 64.4% respectively. High GS was highly predictable of PCSS, BRFS and MFS. Node positivity was the single poor risk factor on MVA whereas biopsy GS, pStage (P = 0.016) and seminal vesicle invasion (P = 0.045) had statistical significance in predicting the MFS.
  
  
  CONCLUSIONS
  RP provides accurate pathologic staging of patients with high risk prostate cancer, allows better stratification of patients for further adjuvant therapy and either as an initial approach or part of a multimodal regimen, can provide durable local control and provides excellent CSS.
authors.forename: J N
authors.initials: JN
authors.lastname: Kulkarni
authors.affiliation: Department of Urology, Bombay Hospital Institute of Medical Sciences, Mumbai, Maharashtra, India.
authors.forename: V S
authors.initials: VS
authors.lastname: Gunavanthe
authors.forename: A
authors.initials: A
authors.lastname: Dhale
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery*; D012307:Risk Factors; D016896:Treatment Outcome