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

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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.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. The Academic Department of Urology, Pathology and Statistics of La Pitié-Salpétrière, Groupe Hospitalo-Universitaire EST, Assistance-Publique Hôpitaux de Paris, 47-83 bvd de l’Hôpital, 75013, Paris, France

    Alexandra Masson-Lecomte, Vincent Hupertan, Eva Comperat, Christophe Vaessen, Emmanuel Chartier-Kastler, Olivier Cussenot, Marc-Olivier Bitker & Morgan Rouprêt

  2. Faculté de Médecine Pierre et Marie Curie, University Paris VI, Paris, France

    Alexandra Masson-Lecomte, Vincent Hupertan, Eva Comperat, Christophe Vaessen, Emmanuel Chartier-Kastler, Olivier Cussenot, Marc-Olivier Bitker & Morgan Rouprêt

  3. CeRePP group, Centre d’Etudes et de Recherche sur les Pathologies Prostatiques, Paris, France

    Alexandra Masson-Lecomte, Vincent Hupertan, Eva Comperat, Christophe Vaessen, Emmanuel Chartier-Kastler, Olivier Cussenot, Marc-Olivier Bitker & Morgan Rouprêt

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  1. Alexandra Masson-Lecomte
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  2. Vincent Hupertan
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  3. Eva Comperat
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  8. Morgan Rouprêt
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Correspondence to Morgan Rouprêt.

Additional information

Study design was approved by the Ethics Committee of the Assistance Publique-Hoˆpitaux de Paris (AP-HP).

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Masson-Lecomte, A., Hupertan, V., Comperat, E. et al. Pathological findings and oncological control afforded by radical prostatectomy in men with high-risk prostate cancer: a single-centre study. World J Urol 29, 665–670 (2011). https://doi.org/10.1007/s00345-010-0608-5

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  • DOI: https://doi.org/10.1007/s00345-010-0608-5

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