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Prognostic evaluation of clinical locally advanced prostate cancer for radical prostatectomy
EAU16th Central European Meeting, 7-8 October 2016, Vienna, Austria
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Prognostic evaluation of clinical locally advanced prostate cancer for radical prostatectomy Eur Urol Suppl 2016; 15(11);e1398
Grygorenko V., Vikarchuk M., Danylets R., Brovko N., Volkov S. State Institution “Institute of Urology of The National Academy of Medical Sciences of Ukraine”, Dept. of Reconstructive Urology and New Technologies, Kyiv, Ukraine INTRODUCTION & OBJECTIVES: Radical prostatectomy is used to treat locally advanced prostate cancer, but the problem of patients’ selection for surgical treatment is controversial. Our aim was to evaluate the prognosis of clinical locally advanced prostate cancer in patients who undergo radical prostatectomy and the classification of these patients into different risk groups based on independent prognostic factors. MATERIAL & METHODS: Among 403 patients who had been undergone radical prostatectomy from August 2002 to February 2015, 102 (25.3%) had clinical locally advanced prostate cancer and were enrolled in the study. All these patients had MRI or CT features of tumor extension beyond the prostatic capsule or invasion of the seminal vesicle. Patients were divided into three different risk groups based on the number of adverse factors present. Low risk patients had PSA level <20 ng/ml, biopsy Gleason score ≤6 and absence of the seminal vesicle invasion of cancer (14 patients). Intermediate risk was noted when the patient had only one of poor prognostic factors (PSA ≥20 ng/ml or biopsy Gleason score≥7 or presence of cancer invasion to the seminal vesicle, 35 patients) and high risk patients had 2 or 3 poor prognostic factors (53 patients). RESULTS: The median follow-up time was 50.6 months (range, 12-129 months) for the whole cohort. The 5-year biochemical recurrence free survival was 51.9%. For patients of low, intermediate and high risk the biochemical recurrence rates were 14.3%, 37.1% and 62.3%, respectively (p<0.05). The patients of intermediate and high risk had clinically significant higher risk of biochemical recurrence than those of low risk with odds ratio 3.5 and 9.9, respectively. CONCLUSIONS: We created a new prognostic classification for patients with clinical locally advanced prostate cancer who undergo radical prostatectomy. According to the number of adverse factors present (PSA>20 ng/ml, biopsy Gleason score≥7, presence of cancer invasion to the seminal vesicle), clinical locally advanced prostate cancer can be divided into three risk groups with significantly different prognoses. Such grouping may help in guiding the individualized treatment for these patients.
Eur Urol Suppl 2016; 15(11);e1398 Powered by TCPDF (www.tcpdf.org)
40
Prognostic evaluation of clinical locally advanced prostate cancer for radical prostatectomy Eur Urol Suppl 2016; 15(11);e1398
Grygorenko V., Vikarchuk M., Danylets R., Brovko N., Volkov S. State Institution “Institute of Urology of The National Academy of Medical Sciences of Ukraine”, Dept. of Reconstructive Urology and New Technologies, Kyiv, Ukraine INTRODUCTION & OBJECTIVES: Radical prostatectomy is used to treat locally advanced prostate cancer, but the problem of patients’ selection for surgical treatment is controversial. Our aim was to evaluate the prognosis of clinical locally advanced prostate cancer in patients who undergo radical prostatectomy and the classification of these patients into different risk groups based on independent prognostic factors. MATERIAL & METHODS: Among 403 patients who had been undergone radical prostatectomy from August 2002 to February 2015, 102 (25.3%) had clinical locally advanced prostate cancer and were enrolled in the study. All these patients had MRI or CT features of tumor extension beyond the prostatic capsule or invasion of the seminal vesicle. Patients were divided into three different risk groups based on the number of adverse factors present. Low risk patients had PSA level <20 ng/ml, biopsy Gleason score ≤6 and absence of the seminal vesicle invasion of cancer (14 patients). Intermediate risk was noted when the patient had only one of poor prognostic factors (PSA ≥20 ng/ml or biopsy Gleason score≥7 or presence of cancer invasion to the seminal vesicle, 35 patients) and high risk patients had 2 or 3 poor prognostic factors (53 patients). RESULTS: The median follow-up time was 50.6 months (range, 12-129 months) for the whole cohort. The 5-year biochemical recurrence free survival was 51.9%. For patients of low, intermediate and high risk the biochemical recurrence rates were 14.3%, 37.1% and 62.3%, respectively (p<0.05). The patients of intermediate and high risk had clinically significant higher risk of biochemical recurrence than those of low risk with odds ratio 3.5 and 9.9, respectively. CONCLUSIONS: We created a new prognostic classification for patients with clinical locally advanced prostate cancer who undergo radical prostatectomy. According to the number of adverse factors present (PSA>20 ng/ml, biopsy Gleason score≥7, presence of cancer invasion to the seminal vesicle), clinical locally advanced prostate cancer can be divided into three risk groups with significantly different prognoses. Such grouping may help in guiding the individualized treatment for these patients.
Eur Urol Suppl 2016; 15(11);e1398 Powered by TCPDF (www.tcpdf.org)