Skip to main content

Advertisement

SpringerLink
Log in

The role of radical prostatectomy in the management of prostatic adenocarcinoma

Biologic factors influencing the likelihood of local and systemic control

  • Published:
World Journal of Urology Aims and scope Submit manuscript

Summary

Radical prostatectomy has been the mainstay of treatment for localized prostate cancer for over 50 years, but its value has been controversial. This report evaluates the impact of this therapeutic modality by assessing the value of various prognostic stratification systems in predicting the clinical outcome. Traditional stratifiers such as clinical stage, pathologic stage, and tumor grade are reviewed, as well as newer biologic parameters such as DNA content determined by automated flow cytometric analysis. Such newer predictors of response may enable an approach of selective enhanced aggressiveness in treating regional, advanced disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Barzell W, Bean MA, Hilaris BS, Whitmore WF Jr (1977) Prostatic adenocarcinoma: relationship of grade and local extent to the pattern of metastases. J Urol 118:278–282

    Google Scholar 

  2. Byar DP, Mostofi FK (1972) Carcinoma of the prostate: prognostic evaluation of certain pathologic features in 208 radical prostatectomies examined by the step-section technique. Cancer 30:5–13

    Google Scholar 

  3. Cifone M, Fidler IJ (1981) Increasing metastatic potential is associated with increasing genetic instability of clones isolated from murine neoplasms. Proc Natl Acad Sci UA 78:6949–6952

    Google Scholar 

  4. Donahue RE, Mani JH, Whitesel JA, Mohr S, Scanavino D, Augspurger RR, Biber RJ, Fauver HE, Wettlaufer JN, Pfister RR (1982) Pelvic lymph node dissection: guide to patient management in clinically locally confined adenocarcinoma of prostate. Urology 20:559–565

    Google Scholar 

  5. Elder JS, Jewett HJ, Walsh PC (1982) Radical perineal prostatectomy for clinical stage B2 carcinoma of the prostate. J Urol 127:704–706

    Google Scholar 

  6. Fordham MVP, Burdge AH, Matthews J, Williams G, Cooke T (1986) Prostatic carcinoma cell DNA content measured by flow cytometry and its relation to clinical outcome. Br J Surg 73:400–403

    Google Scholar 

  7. Frankfurt OS, Chin JL, Englander LS, Greco WR, Pontes JE, Rustum YM (1985) Relationship between DNA ploidy, glandular differentiation, and tumor spread in human prostate cancer. Cancer Res 45:1418–1423

    Google Scholar 

  8. Friedlander ML, Hedley DW, Taylor IW (1984) Clinical and biological significance of aneuploidy in human tumours. J Clin Pathol 37:961–974

    Google Scholar 

  9. Gibbons RP, Correa RJ Jr, Brannen GE, Mason JT (1984) Total prostatectomy for localized prostate cancer. J Urol 131:73–76

    Google Scholar 

  10. Gleason DF (1966) Classification of prostatic carcinomas. Cancer Chemother Rep 50:125–128

    Google Scholar 

  11. Gleason DF, Mellinger GT (1974) The Veterans Administration Cooperative Urological Research Group: prediction of prognosis for prostatic adenocarinoma by combined histological grading and clinical staging. J Urol 111:58–64

    Google Scholar 

  12. Grossman HB, Batata H, Hilaris B, Whitmore WF Jr (1982) 125-I implantation for carcinoma of the prostate: further followup of the first 100 cases. Urology 20:591–598

    Google Scholar 

  13. Gutierrez R (1949) New horizons in surgical management of carcinoma of prostate gland. Am J Surg 78:147–169

    Google Scholar 

  14. Hart IR, Fidler IJ (1981) The implications of tumor heterogeneity for studies on the biology and therapy of cancer metastasis. Biochim Biophys Acta 651:37–50

    Google Scholar 

  15. Jewett HJ (1954) Radical perineal prostatectomy for carcinoma. An analysis of cases at Johns Hopkins Hospital, 1905–1954. JAMA 156:1039–1041

    Google Scholar 

  16. Jewett HJ, Bridge RW, Gray GF Jr, Shelley WM (1968) The palpable nodule of prostatic cancer: results 15 years after radical excision. JAMA 203:403–406

    Google Scholar 

  17. Jewett HJ, Eggleston JC, Yawn DH (1972) Radical prostatectomy in the management of carcinoma of the prostate: probable causes of some therapeutic failures. J Urol 107:1034–1040

    Google Scholar 

  18. Kramer SA, Spahr J, Brendler CB, Glenn JF, Paulson DF (1980) Experience with Gleason's histopathologic grading in prostatic cancer. J Urol 124:223–225

    Google Scholar 

  19. Kramer SA, Cline WA Jr, Farnham R, Carson CC, Cox EB, Hinshaw W, Paulson DF (1981) Prognosis of patients with stage D1 prostatic adenocarcinoma. J Urol 125:817–819

    Google Scholar 

  20. Lee SE, Currin SM, Paulson DF, Walther PJ (1988) Flow cytometric determination of ploidy in prostatic adenocarcinoma: a comparison with seminal vesicle involvement and histopathological grading as a predictor of clinical recurrence. J Urol 140:769–774

    Google Scholar 

  21. McCullough DL, Leadbetter WF (1972) Radical pelvic surgery for locally extensive carcinoma of the prostate. J Urol 108:939–943

    Google Scholar 

  22. Middleton RG, Smith JA Jr, Melzer RB, Hamilton PE (1986) Patient survival and local recurrence rate following radical prostatectomy for prostatic carcinoma. J Urol 136:422–424

    Google Scholar 

  23. Mostofi FK (1975) Grading of prostatic carcinoma. Cancer Chemother Rep 59:111–117

    Google Scholar 

  24. Mukamel E, DeKernion JB, Hannah J, Smith RB, Skinner DG, Goodwin WE (1987) The incidence and significance of seminal vesicle invasion in patients with adenocarcinoma of the prostate. Cancer 59:1535–1538

    Google Scholar 

  25. Oesterling JE, Epstein JI, Walsh PC (1987) Long-term autopsy findings following radical prostatectomy. Urology 29:584–588

    Google Scholar 

  26. Paulson DF (1980) The prognostic role of lymphadenectomy in adenocarcinoma of the prostate. Urol Clin North Am 7:615–622

    Google Scholar 

  27. Paulson DF, Stone AR, Walther PJ, Tucker JA, Cox EB (1986) Radical prostatectomy: anatomical predictors of success or failure. J Urol 136:1041–1043

    Google Scholar 

  28. Sagalowsky AI, Milam H, Reveley LR, Silva FG (1982) Prediction of lymphatic metastases by Gleason histologic grading in prostatic cancer. J Urol 128:951–952

    Google Scholar 

  29. Schellhammer PF (1988) Radical prostatectomy. Patterns of local failure and survival in 67 patients. Urology 31:191–197

    Google Scholar 

  30. Smith JA Jr, Seaman JP, Gleidman JB, Middleton RG (1983) Pelvic lymph node metastasis from prostatic cancer: influence of tumor grade and stage in 452 consecutive patients. J Urol 130:290–292

    Google Scholar 

  31. Stephenson RA, James BC, Gay H, Fair WR, Whitmore WF Jr, Melamed MR (1987) Flow cytometry of prostate cancer: relationship of DNA content to survival. Cancer Res 47:2504–2509

    Google Scholar 

  32. Tavares A, Costa J, Maia J (1973) Correlation between ploidy and prognosis in prostatic carcinoma. J Urol 109:676–679

    Google Scholar 

  33. Turner RD, Belt E (1957) A study of 229 consecutive cases of total perineal prostatectomy for cancer of the prostate. J Urol 77:62–77

    Google Scholar 

  34. Walsh PC, Lepor H (1987) The role of radical prostatectomy in the management of prostatic cancer. Cancer 60:526–537

    Google Scholar 

  35. Westerborn A (1950) Radical treatment of cancer of the prostate by cystovesiculoprostatectomy. Surg Gynecol Obstet 91:751–756

    Google Scholar 

  36. Whitmore WF Jr, Mackenzie AR (1959) Experience with various operative procedures for the total excision of prostatic cancer. Cancer 12:396–405

    Google Scholar 

  37. Winkler HZ, Rainwater LM, Myers RP, Farrow GM, Therneau TM, Zincke H, Lieber MM (1988) Stage D1 prostatic adenocarcinoma: significance of nuclear DNA ploidy patterns studied by flow cytometry. Mayo Clinic Proc 63:103–112

    Google Scholar 

  38. Zetterberg A, Exposti PL (1980) Prognostic significance of nuclear DNA levels in prostatic carcinoma. Scand J Urol Nephrol [Suppl] 55:53–58

    Google Scholar 

  39. Zincke H, Utz DC (1984) Observations on surgical management of carcinoma of prostate with limited nodal metastases. Urology 24:137–145

    Google Scholar 

  40. Zincke H, Farrow GM, Myers RP, Benson RC Jr, Furlow WL, Utz DC (1982) Relationship between grade and stage of adenocarcinoma of the prostate and regional pelvic lymph node metastases. J Urol 128:498–501

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Departments of Surgery/Urology and Experimental Pathology, Duke University School of Medicine, Box 3314, 27710, Durham, North Carolina, USA

    P. J. Walther

Authors
  1. P. J. Walther
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Walther, P.J. The role of radical prostatectomy in the management of prostatic adenocarcinoma. World J Urol 7, 38–44 (1989). https://doi.org/10.1007/BF01576843

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01576843

Keywords

Search

Navigation