Results of radical prostatectomy in men with locally advanced prostate cancer: Multi-institutional pooled analysis

被引:155
作者
Gerber, GS
Thisted, RA
Chodak, GW
Schroder, FH
Frohmuller, HGW
Scardino, PT
Paulson, DF
Middleton, AW
Rukstalis, DB
Smith, JA
Ohori, M
Theiss, M
Schellhammer, PF
机构
[1] UNIV CHICAGO,DEPT STAT,PRITZKER SCH MED,CHICAGO,IL 60637
[2] UNIV CHICAGO,DEPT ANESTHESIA & CRIT CARE,PRITZKER SCH MED,CHICAGO,IL 60637
[3] UNIV CHICAGO,CANC RES CTR,PRITZKER SCH MED,CHICAGO,IL 60637
[4] BAYLOR COLL MED,DEPT UROL,HOUSTON,TX 77030
[5] UNIV WURZBURG,DEPT UROL,WURZBURG,GERMANY
[6] ERASMUS UNIV ROTTERDAM,INST UROL,ROTTERDAM,NETHERLANDS
[7] DUKE UNIV,SCH MED,DEPT SURG,DIV UROL,DURHAM,NC
[8] UNIV UTAH,SCH MED,DEPT UROL,SALT LAKE CITY,UT
[9] VANDERBILT UNIV,SCH MED,DEPT UROL,NASHVILLE,TN 37212
[10] EASTERN VIRGINIA MED SCH,DEPT UROL,NORFOLK,VA 23501
关键词
prostate cancer; radical prostatectomy;
D O I
10.1159/000480794
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Objective: We investigated the disease-specific and metastasis-free survival rates in men with locally advanced (clinical stage T3) prostate cancer who were treated surgically, Methods: A retrospective, multi-institutional pooled analysis of the results of surgical treatment in 345 men with clinical stage T3 disease was performed, Survival curves were generated using the Kaplan-Meier method. Results: Among 298 evaluable patients, pelvic lymphadenectomy alone was performed in 56 men (19%), while 242 men (81%) underwent node dissection and radical prostatectomy. In total, 122 of 298 patients (41%) had nodal metastases and/or seminal vesicle tumor spread, Pathologically organ-confined disease was noted in 27 men (9%). The actuarial 10-year disease-specific and metastasis-free survival rates for all patients managed surgically were 57 and 32%, respectively, For patients with well, moderately and poorly differentiated tumors, cancer-specific survival rates at 10 years were 73, 67 and 29%, respectively. Conclusions: A large number of men with clinical stage T3 prostate cancer have advanced disease and are unlikely to achieve improved longterm survival with surgery alone. Although there may be a role for radical prostatectomy in selected patients with low to intermediate grade tumors, such treatment appears unlikely to result in long-term survival in men with high grade disease, A prospective study is necessary to determine the optimal treatment approach in men with locally advanced prostate cancer.
引用
收藏
页码:385 / 390
页数:6
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