Data Support RP for Localized Advanced Prostate Cancer

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SAN DIEGO—Radical prostatectomy (RP) for locally advanced prostate cancer (PCa) is technically feasible and is associated with good five- and 10-year outcomes, researchers from Mayo Clinic in Rochester, Minn., reported at the American Urological Association annual meeting.

Dharam Kaushik, MD, and colleagues studied 87 men who underwent RP and were found to have pT4 tumors. The median follow-up for these patients was about 10 years. Approximately 46% presented with palpable extracapsular disease. The estimated five-year rates of biochemical recurrence (BCR), systemic progression, and overall survival were 48%, 77%, and 91%, respectively. The five- and 10-year cancer-specific survival rates were 91% and 70%, respectively. Ten patients (11.5%) had local recurrence. Forty patients (46%) had node-positive disease on final pathology.

In multivariate analysis, positive lymph nodes were associated with a twofold increased likelihood of BCR. Both positive lymph nodes and higher pathologic Gleason scores predicted systemic progression.

In their poster presentation, Dr. Kaushik's team concluded that the outcomes were comparable to those of combined radiotherapy and androgen deprivation therapy.

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