Long-term survival achieved with surgery for early-stage prostate cancer
MedWire News: A review of nearly 20 years of surgical data shows that radical prostatectomy offers excellent long-term survival for prostate cancer patients with localized disease.
A team from the Mayo Clinic in Rochester, Minnesota, USA, reviewed prostatectomy records from 1987 to 2004, reflecting the "modern era" of prostate cancer detection using the prostate-specific antigen (PSA) test. They found that only 3% of patients had died from the disease during that time.
"The findings are a testament to the individuals who have helped manage the database over the years, the many Mayo surgeons who performed the procedures with a similar approach, and ultimately, the patients," said R Jeffrey Karnes, who presented the findings at the 84th Annual Meeting of the American Urological Association in Chicago, Illinois, this week.
A total of 10,332 men were identified in the database, all of whom had stage cT1-T2 prostate cancer without neoadjuvant treatment. Karnes and team assessed overall survival, cancer-specific survival (CSS), progression-free survival (PFS), and local recurrence (LR) rates from 5 to 20 years after the patients had undergone radical prostatectomy.
At the time of the review, over 8000 men were still alive, with a median survival time of 19 years, and a mean and median follow-up time of 11 years.
The rates of CSS and PFS were high during follow-up, at 97% and 95%, respectively, while LR rates were low, at 6%, observes the research team.
"These are excellent survival rates," said Karnes.
"They show that radical prostatectomy is a benchmark for treatment of men with prostate cancer that has not spread," he added.
Using a Cox model for multivariate analysis, the team adjusted the findings for pre-operative variables including patient age, disease stage, PSA level, and biopsy Gleason score, and found significant associations between each variable and overall survival.
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By Sarah Guy