Oncological outcomes following radical prostatectomy for patients with pT4 prostate cancer
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Outros Autores: | , , , , , , , , |
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. |
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International Braz J Urol (Online) |
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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 |
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1750318075325972480 |