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The role of radical prostatectomy in the management of patients with high-grade prostate cancer and/or locally advanced disease.
Rodríguez-Covarrubias, Francisco; Castillejos-Molina, Ricardo A; Sotomayor, Mariano; Gabilondo, Fernando; Feria-Bernal, Guillermo.
Afiliação
  • Rodríguez-Covarrubias F; Departamento de Urología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, DF. frodriguez.covarrubias@gmail.com
Rev Invest Clin ; 61(6): 456-60, 2009.
Article em En | MEDLINE | ID: mdl-20184125
OBJECTIVE: To analyze the outcome of patients with clinically localized prostate cancer (PCa) treated with radical prostatectomy (RP) in whom high-grade (HGPCa) and/or locally advanced disease (LAPCa) was found at RP specimen and to evaluate the prognostic value of well-known factors in this subset of patients. MATERIAL AND METHODS: Biochemical progression-free (bPFS) was determined with the Kaplan-Meier method. The effect of PSA, biopsy Gleason, clinical stage and number of adverse pathological factors was assessed with univariate and multivariate analyses. RESULTS: After RP, 87 men had HGPCa (20.7%) or LAPCa (56.3%), with 20 (23%) having both criteria. Mean PSA was 15.5 +/- 14.0 ng/mL and mean follow-up 50.5 +/- 42.6 months. The 5-year bPFS for men with PSA < 10 ng/mL and > or = 10 ng/mL was 54.7% and 35.7%, respectively (p = 0.03). Regarding biopsy Gleason, the 5-year bPFS was 49% and 26% for patients with a score < or = 7 and > 7, respectively (p = 0.002). In the multivariate model, the biopsy Gleason score remained independently associated with biochemical progression. CONCLUSIONS: HGPCa and/or LAPCa confer poor prognosis; however, RP appears to offer acceptable control, particularly when initial PSA is < 10 ng/mL and biopsy Gleason is 7 or less.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Prostatectomia / Neoplasias da Próstata Tipo de estudo: Prognostic_studies Limite: Aged / Humans / Male / Middle aged Idioma: En Revista: Rev Invest Clin Assunto da revista: MEDICINA Ano de publicação: 2009 Tipo de documento: Article País de publicação: México
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Prostatectomia / Neoplasias da Próstata Tipo de estudo: Prognostic_studies Limite: Aged / Humans / Male / Middle aged Idioma: En Revista: Rev Invest Clin Assunto da revista: MEDICINA Ano de publicação: 2009 Tipo de documento: Article País de publicação: México