TY - JOUR
T1 - Pathologic findings at radical prostatectomy
T2 - Risk factors for failure and death
AU - Swanson, Gregory P.
AU - Riggs, Mark
AU - Hermans, Michael
PY - 2007/3
Y1 - 2007/3
N2 - Background: Failure after radical prostatectomy can occur even out to 25 years after surgery. Therefore, it is important that studies have sufficient follow-up to determine more accurately the risk of failure. We evaluated a large cohort of patients for pathologic findings and risk of failure with a median follow-up of 9.5 years. Material and Methods: Between 1985 and 1995, 719 patients underwent radical prostatectomy for lymph node negative prostate cancer. The prostate was inked and evaluated for: (1) positive bladder neck or urethral margin, (2) positive seminal vesicle, (3) into capsule, (4) through capsule, and (5) positive margin. These were considered positive pathologic findings. Results: Overall, 264 (37%) of the patients had biochemical recurrence. For those patients with failure, median time to biochemical recurrence was 2.4 years. Five and 10-year biochemical failure rates were 28% and 38%, respectively. Pathologic stage of disease significantly (<0.0001) predicted for subsequent failure. If there were no positive pathology findings, the recurrence rate was 25%, compared to 63% for any of the 3 findings. Overall, 212 (29%) of the patients have died. Five and 10-year survival were 91% and 75%, respectively. A total of 45 patients (6%) died of prostate cancer. For patients with negative pathology findings, 3% died as a direct consequence of prostate cancer, compared to 13% if the pathology was positive. Of the patients with positive seminal vesicle, 28% died of cancer. Conclusion: Patients with any of the following factors have a risk of failure exceeding 40% and are candidates for studies of adjuvant therapy: seminal vesicle involvement, extension through the capsule, or margin involvement.
AB - Background: Failure after radical prostatectomy can occur even out to 25 years after surgery. Therefore, it is important that studies have sufficient follow-up to determine more accurately the risk of failure. We evaluated a large cohort of patients for pathologic findings and risk of failure with a median follow-up of 9.5 years. Material and Methods: Between 1985 and 1995, 719 patients underwent radical prostatectomy for lymph node negative prostate cancer. The prostate was inked and evaluated for: (1) positive bladder neck or urethral margin, (2) positive seminal vesicle, (3) into capsule, (4) through capsule, and (5) positive margin. These were considered positive pathologic findings. Results: Overall, 264 (37%) of the patients had biochemical recurrence. For those patients with failure, median time to biochemical recurrence was 2.4 years. Five and 10-year biochemical failure rates were 28% and 38%, respectively. Pathologic stage of disease significantly (<0.0001) predicted for subsequent failure. If there were no positive pathology findings, the recurrence rate was 25%, compared to 63% for any of the 3 findings. Overall, 212 (29%) of the patients have died. Five and 10-year survival were 91% and 75%, respectively. A total of 45 patients (6%) died of prostate cancer. For patients with negative pathology findings, 3% died as a direct consequence of prostate cancer, compared to 13% if the pathology was positive. Of the patients with positive seminal vesicle, 28% died of cancer. Conclusion: Patients with any of the following factors have a risk of failure exceeding 40% and are candidates for studies of adjuvant therapy: seminal vesicle involvement, extension through the capsule, or margin involvement.
KW - Biochemical failure
KW - Pathological findings
KW - Prognostic factors
KW - Radical prostatectomy
KW - Survival
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U2 - 10.1016/j.urolonc.2006.06.003
DO - 10.1016/j.urolonc.2006.06.003
M3 - Article
C2 - 17349524
AN - SCOPUS:33847414931
VL - 25
SP - 110
EP - 114
JO - Urologic Oncology: Seminars and Original Investigations
JF - Urologic Oncology: Seminars and Original Investigations
SN - 1078-1439
IS - 2
ER -