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The long-term outcomes of radical prostatectomy for very high-risk prostate cancer pT3b-T4 N0-1 on definitive histopathology

INTRODUCTION: The study aimed to assess long-term outcomes in patients with very high-risk prostate cancer (PCa) – pT3b-T4 N0-1 using the definitive histopathology following radical retropubic prostatectomy (RRP). MATERIAL AND METHODS: We have analyzed 114 patients with very high-risk PCa who underw...

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Autores principales: Kliment, Jan, Elias, Boris, Baluchova, Katarina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Polish Urological Association 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5407328/
https://www.ncbi.nlm.nih.gov/pubmed/28461982
http://dx.doi.org/10.5173/ceju.2017.897
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author Kliment, Jan
Elias, Boris
Baluchova, Katarina
Kliment, Jan
author_facet Kliment, Jan
Elias, Boris
Baluchova, Katarina
Kliment, Jan
author_sort Kliment, Jan
collection PubMed
description INTRODUCTION: The study aimed to assess long-term outcomes in patients with very high-risk prostate cancer (PCa) – pT3b-T4 N0-1 using the definitive histopathology following radical retropubic prostatectomy (RRP). MATERIAL AND METHODS: We have analyzed 114 patients with very high-risk PCa who underwent RRP between 1995 and 2012. Biochemical and clinical progression-free survival (BPFS, CPFS), cancer-specific and overall survival (CSS, OS) curves were constructed according to the Kaplan-Meier method. Univariate and multivariate Cox regression analysis was utilized to determine predictability of clinical and pathological parameters. RESULTS: At the 5 and 10 year mark, the BPFS was 71.3% and 35%, respectively; the CPFS was 86.8% and 69.2%, respectively; the CSS was 98% and 76.3%, respectively and the OS was 90.3% and 62.4%, respectively. Sixteen patients (14%) had lymph-node involvement. Positive surgical margins were present in 64 (56.1%) patients. Neo-adjuvant androgen deprivation therapy (ADT) was received by 22 (19.3%) patients. Adjuvant ADT alone or in combination with external radiotherapy was received by 59 (51.8%) patients. No adjuvant treatment was needed in 29 (25.4%) patients. In univariate and multivariate analysis, neo-adjuvant ADT was associated with an increased risk of BPFS and CPFS. CONCLUSIONS: Therapy applied in patients with very high-risk PCa was multimodal in most cases, with RP usually being the first step. The study confirmed that very high-risk PCa is a heterogeneous disease. A significant subset of patients remain without adjuvant therapy treatment.
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spelling pubmed-54073282017-05-01 The long-term outcomes of radical prostatectomy for very high-risk prostate cancer pT3b-T4 N0-1 on definitive histopathology Kliment, Jan Elias, Boris Baluchova, Katarina Kliment, Jan Cent European J Urol Original Paper INTRODUCTION: The study aimed to assess long-term outcomes in patients with very high-risk prostate cancer (PCa) – pT3b-T4 N0-1 using the definitive histopathology following radical retropubic prostatectomy (RRP). MATERIAL AND METHODS: We have analyzed 114 patients with very high-risk PCa who underwent RRP between 1995 and 2012. Biochemical and clinical progression-free survival (BPFS, CPFS), cancer-specific and overall survival (CSS, OS) curves were constructed according to the Kaplan-Meier method. Univariate and multivariate Cox regression analysis was utilized to determine predictability of clinical and pathological parameters. RESULTS: At the 5 and 10 year mark, the BPFS was 71.3% and 35%, respectively; the CPFS was 86.8% and 69.2%, respectively; the CSS was 98% and 76.3%, respectively and the OS was 90.3% and 62.4%, respectively. Sixteen patients (14%) had lymph-node involvement. Positive surgical margins were present in 64 (56.1%) patients. Neo-adjuvant androgen deprivation therapy (ADT) was received by 22 (19.3%) patients. Adjuvant ADT alone or in combination with external radiotherapy was received by 59 (51.8%) patients. No adjuvant treatment was needed in 29 (25.4%) patients. In univariate and multivariate analysis, neo-adjuvant ADT was associated with an increased risk of BPFS and CPFS. CONCLUSIONS: Therapy applied in patients with very high-risk PCa was multimodal in most cases, with RP usually being the first step. The study confirmed that very high-risk PCa is a heterogeneous disease. A significant subset of patients remain without adjuvant therapy treatment. Polish Urological Association 2017-01-03 2017 /pmc/articles/PMC5407328/ /pubmed/28461982 http://dx.doi.org/10.5173/ceju.2017.897 Text en Copyright by Polish Urological Association http://creativecommons.org/licenses/by-nc-sa/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
spellingShingle Original Paper
Kliment, Jan
Elias, Boris
Baluchova, Katarina
Kliment, Jan
The long-term outcomes of radical prostatectomy for very high-risk prostate cancer pT3b-T4 N0-1 on definitive histopathology
title The long-term outcomes of radical prostatectomy for very high-risk prostate cancer pT3b-T4 N0-1 on definitive histopathology
title_full The long-term outcomes of radical prostatectomy for very high-risk prostate cancer pT3b-T4 N0-1 on definitive histopathology
title_fullStr The long-term outcomes of radical prostatectomy for very high-risk prostate cancer pT3b-T4 N0-1 on definitive histopathology
title_full_unstemmed The long-term outcomes of radical prostatectomy for very high-risk prostate cancer pT3b-T4 N0-1 on definitive histopathology
title_short The long-term outcomes of radical prostatectomy for very high-risk prostate cancer pT3b-T4 N0-1 on definitive histopathology
title_sort long-term outcomes of radical prostatectomy for very high-risk prostate cancer pt3b-t4 n0-1 on definitive histopathology
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5407328/
https://www.ncbi.nlm.nih.gov/pubmed/28461982
http://dx.doi.org/10.5173/ceju.2017.897
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