NEW ORLEANS—Radical prostatectomy (RP) is associated with excellent long-term outcomes in patients with localized prostate cancer (PCa), Italian researchers reported at the 2015 American Urological Association annual meeting.
In a study of 529 PCa patients who underwent RP from 1985–1994, Giorgio Gandaglia, MD, of IRCCS Ospedale San Raffaele in Milan, and colleagues found that overall 20-year rates of biochemical recurrence (BCR)-free, clinical recurrence-free, and cancer-specific survival were 55.1%, 71.6%, and 78.2%, respectively.
The median follow-up for survivors was 168 months. The 5-year BCR-free survival rates increased according to the time elapsed between surgery and patient evaluation: the rates were 87.3%, 89.2%, 89.5%, 92.0%, and 92.5% when the time elapsed was 1, 2, 3, 4, and 5 years, respectively, Dr. Gandaglia’s group reported. The median time from BCR to cancer-specific mortality (CSM) was 79 months.
In multivariate analysis, time from surgery to BCR was a significant predictor of CSM. Patients experiencing BCR after 10 years from surgery remained at higher risk of CSM compared with their counterparts free from recurrence at the same point, even after adjusting for the risk of other-cause mortality. CSM rates increased along with D’Amico risk groups and age. For example, the rate was 3.3% for low-risk patients younger than 65 years and 30.9% for high-risk patients aged 65 years and older.