World Journal of Urology

, Volume 29, Issue 5, pp 665–670

Pathological findings and oncological control afforded by radical prostatectomy in men with high-risk prostate cancer: a single-centre study

  • Alexandra Masson-Lecomte
  • Vincent Hupertan
  • Eva Comperat
  • Christophe Vaessen
  • Emmanuel Chartier-Kastler
  • Olivier Cussenot
  • Marc-Olivier Bitker
  • Morgan Rouprêt
Original Article

DOI: 10.1007/s00345-010-0608-5

Cite this article as:
Masson-Lecomte, A., Hupertan, V., Comperat, E. et al. World J Urol (2011) 29: 665. doi:10.1007/s00345-010-0608-5

Abstract

Objective

To assess pathological findings and oncological control afforded by radical prostatectomy (RP) in high-risk prostate cancers (PCa) at our institution.

Materials and methods

We performed a retrospective review of prostate cancer patients who underwent RP between 1995 and 2006 for a high-risk prostate cancer (i.e., PSA >20 or biopsy Gleason ≥8 or clinical stage ≥T2c). Biochemical recurrence was defined as a single rise in PSA levels over 0.2 ng/ml after surgery. Survival curves were elaborated by the Kaplan–Meier method and Cox proportional hazard regression analysis. For each patient, a prognostic score for recurrence was estimated, and a prediction model was then constructed.

Results

Overall, 138 patients were included and followed for a median time of 53 months. Mean age at diagnosis was 63.4 years (range 39–80) and mean pre-operative PSA was 15.5 ng/ml (range 7.4–31). The median follow-up was 53 months (range 6–166). Overall, 82 patients (59%) had biochemical recurrence. The five-year PSA recurrence-free survival rate was 40%. In univariate analysis, clinically palpable tumours (T2–T3) (P = 0.032), biopsy Gleason score ≥8 (P = 0.031), seminal vesicle invasion (pT3b), positive margins and positive lymph nodes (P < 0.001) were significantly associated with recurrence. In multivariate analysis, the biopsy Gleason score ≥8, seminal vesicle invasion, positive margins and positive lymph nodes predicted recurrence (P < 0.05).

Conclusions

RP affords an acceptable oncological control at first-line treatment of selected patients with high-risk PCa. However, in certain cases, surgery alone might not be sufficient and may be part of a multimodal treatment including either adjuvant radiotherapy or androgen deprivation.

Keywords

Prostatic neoplasmsProstate-specific antigenOutcomeBiochemical recurrenceRadical prostatectomyGleason score

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Alexandra Masson-Lecomte
    • 1
    • 2
    • 3
  • Vincent Hupertan
    • 1
    • 2
    • 3
  • Eva Comperat
    • 1
    • 2
    • 3
  • Christophe Vaessen
    • 1
    • 2
    • 3
  • Emmanuel Chartier-Kastler
    • 1
    • 2
    • 3
  • Olivier Cussenot
    • 1
    • 2
    • 3
  • Marc-Olivier Bitker
    • 1
    • 2
    • 3
  • Morgan Rouprêt
    • 1
    • 2
    • 3
  1. 1.The Academic Department of Urology, Pathology and Statistics of La Pitié-SalpétrièreGroupe Hospitalo-Universitaire EST, Assistance-Publique Hôpitaux de ParisParisFrance
  2. 2.Faculté de Médecine Pierre et Marie CurieUniversity Paris VIParisFrance
  3. 3.CeRePP group, Centre d’Etudes et de Recherche sur les Pathologies ProstatiquesParisFrance