Oncological outcomes following radical prostatectomy for patients with pT4 prostate cancer

Detalhes bibliográficos
Autor(a) principal: Kaushik,Dharam
Data de Publicação: 2016
Outros Autores: Boorjian,Stephen A., Thompson,R. Houston, Eisenberg,Manuel S., Carlson,Rachel E., Bergstralh,Eric J., Frank,Igor, Gettman,Matthew T., Tollefson,Matthew K., Karnes,R. Jeffrey
Tipo de documento: Artigo
Idioma: eng
Título da fonte: International Braz J Urol (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382016000601091
Resumo: ABSTRACT Objectives: Radical prostatectomy (RP) for locally advanced prostate cancer may reduce the risk of metastasis and cancer-specific death. Herein, we evaluated the outcomes for patients with pT4 disease treated with RP. Materials and methods: Among 19,800 men treated with RP at Mayo Clinic from 1987 to 2010, 87 were found to have pT4 tumors. Biochemical recurrence (BCR)-free survival, systemic progression (SP) free survival and overall survival (OS) were estimated using the Kaplan-Meier method and compared with the log-rank test. Cox proportional hazards regression models were used to assess the association of clinic-pathological features with outcome. Results: Median follow-up was 9.8 years (IQR 3.6, 13.4). Of the 87 patients, 50 (57.5%) were diagnosed with BCR, 30 (34.5%) developed SP, and 38 (43.7%) died, with 11 (12.6%) dying of prostate cancer. Adjuvant androgen deprivation therapy was administered to 77 men, while 32 received adjuvant external beam radiation therapy. Ten-year BCR-free survival, SP-free survival, and OS was 37%, 64%, and 70% respectively. On multivariate analysis, the presence of positive lymph nodes was marginally significantly associated with patients' risk of BCR (HR: 1.94; p=0.05), while both positive lymph nodes (HR 2.96; p=0.02) and high pathologic Gleason score (HR 1.95; p=0.03) were associated with SP. Conclusions: Patients with pT4 disease may experience long-term survival following RP, and as such, when technically feasible, surgical resection should be considered in the multimodal treatment approach to these men.
id SBU-1_83784b70ed2f967ccd0ff12e0ec60c54
oai_identifier_str oai:scielo:S1677-55382016000601091
network_acronym_str SBU-1
network_name_str International Braz J Urol (Online)
repository_id_str
spelling Oncological outcomes following radical prostatectomy for patients with pT4 prostate cancerProstatic NeoplasmsProstatectomyNeoplasm MetastasisABSTRACT Objectives: Radical prostatectomy (RP) for locally advanced prostate cancer may reduce the risk of metastasis and cancer-specific death. Herein, we evaluated the outcomes for patients with pT4 disease treated with RP. Materials and methods: Among 19,800 men treated with RP at Mayo Clinic from 1987 to 2010, 87 were found to have pT4 tumors. Biochemical recurrence (BCR)-free survival, systemic progression (SP) free survival and overall survival (OS) were estimated using the Kaplan-Meier method and compared with the log-rank test. Cox proportional hazards regression models were used to assess the association of clinic-pathological features with outcome. Results: Median follow-up was 9.8 years (IQR 3.6, 13.4). Of the 87 patients, 50 (57.5%) were diagnosed with BCR, 30 (34.5%) developed SP, and 38 (43.7%) died, with 11 (12.6%) dying of prostate cancer. Adjuvant androgen deprivation therapy was administered to 77 men, while 32 received adjuvant external beam radiation therapy. Ten-year BCR-free survival, SP-free survival, and OS was 37%, 64%, and 70% respectively. On multivariate analysis, the presence of positive lymph nodes was marginally significantly associated with patients' risk of BCR (HR: 1.94; p=0.05), while both positive lymph nodes (HR 2.96; p=0.02) and high pathologic Gleason score (HR 1.95; p=0.03) were associated with SP. Conclusions: Patients with pT4 disease may experience long-term survival following RP, and as such, when technically feasible, surgical resection should be considered in the multimodal treatment approach to these men.Sociedade Brasileira de Urologia2016-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382016000601091International braz j urol v.42 n.6 2016reponame:International Braz J Urol (Online)instname:Sociedade Brasileira de Urologia (SBU)instacron:SBU10.1590/s1677-5538.ibju.2016.0290info:eu-repo/semantics/openAccessKaushik,DharamBoorjian,Stephen A.Thompson,R. HoustonEisenberg,Manuel S.Carlson,Rachel E.Bergstralh,Eric J.Frank,IgorGettman,Matthew T.Tollefson,Matthew K.Karnes,R. Jeffreyeng2016-11-22T00:00:00Zoai:scielo:S1677-55382016000601091Revistahttp://www.brazjurol.com.br/ONGhttps://old.scielo.br/oai/scielo-oai.php||brazjurol@brazjurol.com.br1677-61191677-5538opendoar:2016-11-22T00:00International Braz J Urol (Online) - Sociedade Brasileira de Urologia (SBU)false
dc.title.none.fl_str_mv Oncological outcomes following radical prostatectomy for patients with pT4 prostate cancer
title Oncological outcomes following radical prostatectomy for patients with pT4 prostate cancer
spellingShingle Oncological outcomes following radical prostatectomy for patients with pT4 prostate cancer
Kaushik,Dharam
Prostatic Neoplasms
Prostatectomy
Neoplasm Metastasis
title_short Oncological outcomes following radical prostatectomy for patients with pT4 prostate cancer
title_full Oncological outcomes following radical prostatectomy for patients with pT4 prostate cancer
title_fullStr Oncological outcomes following radical prostatectomy for patients with pT4 prostate cancer
title_full_unstemmed Oncological outcomes following radical prostatectomy for patients with pT4 prostate cancer
title_sort Oncological outcomes following radical prostatectomy for patients with pT4 prostate cancer
author Kaushik,Dharam
author_facet Kaushik,Dharam
Boorjian,Stephen A.
Thompson,R. Houston
Eisenberg,Manuel S.
Carlson,Rachel E.
Bergstralh,Eric J.
Frank,Igor
Gettman,Matthew T.
Tollefson,Matthew K.
Karnes,R. Jeffrey
author_role author
author2 Boorjian,Stephen A.
Thompson,R. Houston
Eisenberg,Manuel S.
Carlson,Rachel E.
Bergstralh,Eric J.
Frank,Igor
Gettman,Matthew T.
Tollefson,Matthew K.
Karnes,R. Jeffrey
author2_role author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Kaushik,Dharam
Boorjian,Stephen A.
Thompson,R. Houston
Eisenberg,Manuel S.
Carlson,Rachel E.
Bergstralh,Eric J.
Frank,Igor
Gettman,Matthew T.
Tollefson,Matthew K.
Karnes,R. Jeffrey
dc.subject.por.fl_str_mv Prostatic Neoplasms
Prostatectomy
Neoplasm Metastasis
topic Prostatic Neoplasms
Prostatectomy
Neoplasm Metastasis
description ABSTRACT Objectives: Radical prostatectomy (RP) for locally advanced prostate cancer may reduce the risk of metastasis and cancer-specific death. Herein, we evaluated the outcomes for patients with pT4 disease treated with RP. Materials and methods: Among 19,800 men treated with RP at Mayo Clinic from 1987 to 2010, 87 were found to have pT4 tumors. Biochemical recurrence (BCR)-free survival, systemic progression (SP) free survival and overall survival (OS) were estimated using the Kaplan-Meier method and compared with the log-rank test. Cox proportional hazards regression models were used to assess the association of clinic-pathological features with outcome. Results: Median follow-up was 9.8 years (IQR 3.6, 13.4). Of the 87 patients, 50 (57.5%) were diagnosed with BCR, 30 (34.5%) developed SP, and 38 (43.7%) died, with 11 (12.6%) dying of prostate cancer. Adjuvant androgen deprivation therapy was administered to 77 men, while 32 received adjuvant external beam radiation therapy. Ten-year BCR-free survival, SP-free survival, and OS was 37%, 64%, and 70% respectively. On multivariate analysis, the presence of positive lymph nodes was marginally significantly associated with patients' risk of BCR (HR: 1.94; p=0.05), while both positive lymph nodes (HR 2.96; p=0.02) and high pathologic Gleason score (HR 1.95; p=0.03) were associated with SP. Conclusions: Patients with pT4 disease may experience long-term survival following RP, and as such, when technically feasible, surgical resection should be considered in the multimodal treatment approach to these men.
publishDate 2016
dc.date.none.fl_str_mv 2016-12-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382016000601091
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382016000601091
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/s1677-5538.ibju.2016.0290
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Sociedade Brasileira de Urologia
publisher.none.fl_str_mv Sociedade Brasileira de Urologia
dc.source.none.fl_str_mv International braz j urol v.42 n.6 2016
reponame:International Braz J Urol (Online)
instname:Sociedade Brasileira de Urologia (SBU)
instacron:SBU
instname_str Sociedade Brasileira de Urologia (SBU)
instacron_str SBU
institution SBU
reponame_str International Braz J Urol (Online)
collection International Braz J Urol (Online)
repository.name.fl_str_mv International Braz J Urol (Online) - Sociedade Brasileira de Urologia (SBU)
repository.mail.fl_str_mv ||brazjurol@brazjurol.com.br
_version_ 1750318075325972480