Favorable disease-free survival for stage T3 radical prostatectomy patients
MedWire News: Treating clinical disease stage T3 prostate cancer patients with radical prostatectomy (RP) results in favorable cancer-specific survival (CSS) and freedom from biochemical progression-free survival (BPFS) rates, say researchers.
“RP for cT3 prostate cancer had a favorable outcome in the present series, with a 10-year disease specific survival rate that was comparable with published rates for the outcome of radiotherapy combined with androgen deprivation therapy,” write Chris Bangma (Erasmus MC University Medical Center, Rotterdam, The Netherlands), and colleagues.
The maximal treatment of stage T3 disease – indicating extracapsular extension of either unilateral or bilateral disease, and possible seminal vesicle invasion – is currently disputed, explains the research team, who note that radiotherapy and hormone therapy are currently considered the standard treatment options for stage T3 patients.
The researchers, who present their results in the journal BJU International, analyzed RP outcomes including BPFS, CSS, and overall survival (OS) in a cohort of 164 RP patients with stage T3 disease. The patients were followed-up for a median of 100 months after surgery during which time 62 patients died, including 32 from prostate cancer.
BPFS, where biochemical progression was defined as two consecutive prostate-specific antigen (PSA) level rises of more than 0.2 ng/ml after surgery, was 50.4%, 43.0%, and 38.3% at 5, 10, and 15 years after RP, respectively.
CSS rates were high at 5, 10, and 15 years after surgery, at 93.4%, 80.3%, and 66.3%, respectively, and OS was 87.1%, 67.2%, and 37.4%.
On multivariate analysis, the clinical variables shown to be most closely associated with BPFS were surgical tumor grade, node status (positive vs negative), and preoperative PSA levels, giving significant hazard ratios (HR) of 1.49, 3.18, and 1.02, respectively. Surgical tumor grade, margin status, and node status were all significant predictors of CSS, with HRs of 4.92, 4.12, and 3.89, respectively.
Previous studies of RP in stage T3 patients have shown that CSS at 5 and 10 years can range between 85–100% and 57–100%, thus Bangma et al recognize that RP “might be one part of a multimodal approach to treat locally advanced prostate cancer.”
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By Sarah Guy