The Long-Term Outcomes after Radical Prostatectomy of Patients with Pathologic Gleason 8–10 Disease
Background. We explored the long-term clinical outcomes including metastases-free survival and prostate cancer-specific survival (PCSS) in patients with pathologic Gleason 8–10 disease after radical prostatectomy (RP). Methods. We report on 91 patients with PCSS data with a median followup of 8.2 ye...
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Wiley
2012-01-01
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| Series: | Advances in Urology |
| Online Access: | http://dx.doi.org/10.1155/2012/428098 |
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| author | Dan Lewinshtein Brandon Teng Ashley Valencia Robert Gibbons Christopher R. Porter |
| author_facet | Dan Lewinshtein Brandon Teng Ashley Valencia Robert Gibbons Christopher R. Porter |
| author_sort | Dan Lewinshtein |
| collection | DOAJ |
| description | Background. We explored the long-term clinical outcomes including metastases-free survival and prostate cancer-specific survival (PCSS) in patients with pathologic Gleason 8–10 disease after radical prostatectomy (RP). Methods. We report on 91 patients with PCSS data with a median followup of 8.2 years after RP performed between 1988 and 1997. Cox regression and Kaplan-Meier analysis were used to evaluate year of surgery, pathologic stage, and surgical margin status as predictors of PCSM. Results. Median age was 65 years (IQR: 61–9), and median PSA was 9.7 ng/ml (IQR: 6.1–13.4). Of all patients, 62 (68.9%) had stage T3 disease or higher, and 48 (52.7%) had a positive surgical margin. On multivariate analysis, none of the predictors were statistically significant. Of all patients, the predicted 10-year BCR-free survival, mets-free survival, and PCSS were 59% (CI: 53%–65%), 88% (CI: 84%–92%), and 94% (CI: 91%–97%), respectively. Conclusions. We have demonstrated that cancer control is durable even 10 years after RP in those with pathologic Gleason 8–10 disease. Although 40% will succumb to BCR, only 6% of patients died of their disease. These results support the use of RP for patients with high-risk localized prostate cancer. |
| format | Article |
| id | doaj-art-c2d2c3c39e8f44a6a954a0b50c7d73e7 |
| institution | OA Journals |
| issn | 1687-6369 1687-6377 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
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| series | Advances in Urology |
| spelling | doaj-art-c2d2c3c39e8f44a6a954a0b50c7d73e72025-08-20T02:19:02ZengWileyAdvances in Urology1687-63691687-63772012-01-01201210.1155/2012/428098428098The Long-Term Outcomes after Radical Prostatectomy of Patients with Pathologic Gleason 8–10 DiseaseDan Lewinshtein0Brandon Teng1Ashley Valencia2Robert Gibbons3Christopher R. Porter4Section of Urology and Renal Transplantation, Virginia Mason Medical Center, 1100 Ninth Avenue, C7-URO, Seattle, WA 98101, USASection of Urology and Renal Transplantation, Virginia Mason Medical Center, 1100 Ninth Avenue, C7-URO, Seattle, WA 98101, USASection of Urology and Renal Transplantation, Virginia Mason Medical Center, 1100 Ninth Avenue, C7-URO, Seattle, WA 98101, USASection of Urology and Renal Transplantation, Virginia Mason Medical Center, 1100 Ninth Avenue, C7-URO, Seattle, WA 98101, USASection of Urology and Renal Transplantation, Virginia Mason Medical Center, 1100 Ninth Avenue, C7-URO, Seattle, WA 98101, USABackground. We explored the long-term clinical outcomes including metastases-free survival and prostate cancer-specific survival (PCSS) in patients with pathologic Gleason 8–10 disease after radical prostatectomy (RP). Methods. We report on 91 patients with PCSS data with a median followup of 8.2 years after RP performed between 1988 and 1997. Cox regression and Kaplan-Meier analysis were used to evaluate year of surgery, pathologic stage, and surgical margin status as predictors of PCSM. Results. Median age was 65 years (IQR: 61–9), and median PSA was 9.7 ng/ml (IQR: 6.1–13.4). Of all patients, 62 (68.9%) had stage T3 disease or higher, and 48 (52.7%) had a positive surgical margin. On multivariate analysis, none of the predictors were statistically significant. Of all patients, the predicted 10-year BCR-free survival, mets-free survival, and PCSS were 59% (CI: 53%–65%), 88% (CI: 84%–92%), and 94% (CI: 91%–97%), respectively. Conclusions. We have demonstrated that cancer control is durable even 10 years after RP in those with pathologic Gleason 8–10 disease. Although 40% will succumb to BCR, only 6% of patients died of their disease. These results support the use of RP for patients with high-risk localized prostate cancer.http://dx.doi.org/10.1155/2012/428098 |
| spellingShingle | Dan Lewinshtein Brandon Teng Ashley Valencia Robert Gibbons Christopher R. Porter The Long-Term Outcomes after Radical Prostatectomy of Patients with Pathologic Gleason 8–10 Disease Advances in Urology |
| title | The Long-Term Outcomes after Radical Prostatectomy of Patients with Pathologic Gleason 8–10 Disease |
| title_full | The Long-Term Outcomes after Radical Prostatectomy of Patients with Pathologic Gleason 8–10 Disease |
| title_fullStr | The Long-Term Outcomes after Radical Prostatectomy of Patients with Pathologic Gleason 8–10 Disease |
| title_full_unstemmed | The Long-Term Outcomes after Radical Prostatectomy of Patients with Pathologic Gleason 8–10 Disease |
| title_short | The Long-Term Outcomes after Radical Prostatectomy of Patients with Pathologic Gleason 8–10 Disease |
| title_sort | long term outcomes after radical prostatectomy of patients with pathologic gleason 8 10 disease |
| url | http://dx.doi.org/10.1155/2012/428098 |
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