Long-term cancer control after radical prostatectomy and bilateral pelvic lymph node dissection for pT3bN0M0 prostate cancer in the prostate-specific antigen era

被引:7
作者
Fairey, Adrian S. [1 ]
Daneshmand, Siamak [1 ]
Skinner, Eila C. [2 ]
Schuckman, Anne [1 ]
Cai, Jie [1 ]
Lieskovsky, Gary [1 ]
机构
[1] Univ Calif Los Angeles, Keck Med Ctr USC, USC Inst Urol, Los Angeles, CA 90095 USA
[2] Stanford Univ, Dept Urol, Stanford, CA 94305 USA
关键词
Prostate cancer; PSA; Prostatectomy; Metastasis; Survival; Recurrence; SEMINAL-VESICLE INVASION; ADJUVANT RADIOTHERAPY; RADIATION-THERAPY; POSTOPERATIVE RADIOTHERAPY; SALVAGE RADIOTHERAPY; FOLLOW-UP; ADENOCARCINOMA; SURVIVAL; RISK; INVOLVEMENT;
D O I
10.1016/j.urolonc.2013.03.005
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Objectives: We evaluated long-term cancer control outcomes of radical prostatectomy and bilateral pelvic lymph node dissection (RP) for pT3bN0M0 prostate cancer in the era of prostate-specific antigen (PSA) screening. Materials and methods: A retrospective analysis of prospectively collected data from the University of Southern California Prostate Cancer Database was performed. Between 1987 and 2008, 229 men underwent open RP for pT3bN0M0 prostate cancer. The cohort was divided into early (1987-1997) and contemporary (1998-2008) PSA eras. The Kaplan-Meier method and Cox proportional regression models were used to analyze clinical recurrence (CR) and biochemical recurrence (BCR). Results: The median follow-up duration was 14.5 years (range, 0.2-21.1 y). The predicted 10-year freedom from CR and BCR rates for men treated in the early and contemporary PSA eras were 73% and 95% (Log-rank P = 0.001) and 65% and 73% (Log-rank P = 0.055), respectively. Multivariable analysis showed that pathologic Gleason grade 8-10 (CR: hazard ratio [BR] = 5.11; 95% confidence interval [CI] = 1.72-15.20; P = 0.003; BCR: HR = 3.47; 95% CI = 1.60-7.48; P = 0.002) and contemporary PSA era (CR: HR = 0.15; 95% CI = 0.06-0.41; P < 0.001; BCR: HR = 0.49; 95% CI = 0.28-0.86; P = 0.013) were independently associated with cancer control. Adjuvant radiation therapy and positive surgical margins were not independently associated with outcomes. Conclusions: RP conferred long-term cancer control in men with pT3bN0M0 prostate cancer treated in the PSA era. Pathologic Gleason grade 8-10 and treatment in the early PSA era were independently associated with poorer cancer control outcomes. (C) 2014 Published by Elsevier Inc.
引用
收藏
页码:85 / 91
页数:7
相关论文
共 27 条
[21]   Salvage radiotherapy for recurrent prostate cancer after radical prostatectomy [J].
Stephenson, AJ ;
Shariat, SF ;
Zelefsky, MJ ;
Kattan, MW ;
Butler, EB ;
Teh, BS ;
Klein, EA ;
Kupelian, PA ;
Roehrborn, CG ;
Pistenmaa, DA ;
Pacholke, HD ;
Liauw, SL ;
Katz, MS ;
Leibel, SA ;
Scardino, PT ;
Slawin, KM .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2004, 291 (11) :1325-1332
[22]   Postoperative Radiation Therapy for Pathologically Advanced Prostate Cancer After Radical Prostatectomy [J].
Stephenson, Andrew J. ;
Bolla, Michel ;
Briganti, Alberto ;
Cozzarini, Cesare ;
Moul, Judd W. ;
Roach, Mack, III ;
van Poppel, Hein ;
Zietman, Anthony .
EUROPEAN UROLOGY, 2012, 61 (03) :443-451
[23]   Adjuvant Radiotherapy for Pathological T3N0M0 Prostate Cancer Significantly Reduces Risk of Metastases and Improves Survival: Long-Term Followup of a Randomized Clinical Trial [J].
Thompson, Ian M. ;
Tangen, Catherine M. ;
Paradelo, Jorge ;
Lucia, M. Scott ;
Miller, Gary ;
Troyer, Dean ;
Messing, Edward ;
Forman, Jeffrey ;
Chin, Joseph ;
Swanson, Gregory ;
Canby-Hagino, Edith ;
Crawford, E. David .
JOURNAL OF UROLOGY, 2009, 181 (03) :956-962
[24]   Identification of patients with prostate cancer who benefit from immediate postoperative radiotherapy:: EORTC 22911 [J].
Van der Kwast, Theodorus H. ;
Bolla, Michel ;
Van Poppel, Hein ;
Van Cangh, Paul ;
Vekemans, Kris ;
Da Pozzo, Luigi ;
Bosset, Jean-Francois ;
Kurth, Karl H. ;
Schroeder, Fritz H. ;
Collette, Laurence .
JOURNAL OF CLINICAL ONCOLOGY, 2007, 25 (27) :4178-4186
[25]   ADJUVANT RADIOTHERAPY AFTER RADICAL PROSTATECTOMY IN PATIENTS WITH PATHOLOGICALLY HIGH RISK PROSTATE CANCER: 10-YEAR FOLLOW-UP RESULTS [J].
Van Poppel, H. ;
Bolla, M. ;
Tombal, B. ;
Vekemans, K. ;
Da Pozzo, L. ;
De Reijke, Th M. ;
Verbaeys, A. ;
Bosset, J. F. ;
Van Velthoven, R. ;
Colombel, M. ;
Van De Beek, C. ;
Verhagen, P. ;
Van Den Bergh, A. C. M. ;
Sternberg, C. ;
Gasser, T. ;
Van Tienhoven, G. ;
Scalliet, P. ;
Haustermans, K. ;
Collette, L. .
EUROPEAN UROLOGY SUPPLEMENTS, 2011, 10 (02) :93-93
[26]   PATHOGENESIS AND BIOLOGICAL SIGNIFICANCE OF SEMINAL-VESICLE INVASION IN PROSTATIC ADENOCARCINOMA [J].
VILLERS, AA ;
MCNEAL, JE ;
REDWINE, EA ;
FREIHA, FS ;
STAMEY, TA .
JOURNAL OF UROLOGY, 1990, 143 (06) :1183-1187
[27]   Phase III Postoperative Adjuvant Radiotherapy After Radical Prostatectomy Compared With Radical Prostatectomy Alone in pT3 Prostate Cancer With Postoperative Undetectable Prostate-Specific Antigen: ARO 96-02/AUO AP 09/95 [J].
Wiegel, Thomas ;
Bottke, Dirk ;
Steiner, Ursula ;
Siegmann, Alessandra ;
Golz, Reinhard ;
Stoerkel, Stephan ;
Willich, Norman ;
Semjonow, Axel ;
Souchon, Rainer ;
Stoeckle, Michael ;
Ruebe, Christian ;
Weissbach, Lothar ;
Althaus, Peter ;
Rebmann, Udo ;
Kaelble, Tilman ;
Feldmann, Horst Juergen ;
Wirth, Manfred ;
Hinke, Axel ;
Hinkelbein, Wolfgang ;
Miller, Kurt .
JOURNAL OF CLINICAL ONCOLOGY, 2009, 27 (18) :2924-2930