scholarly journals Radical Prostatectomy: An Option for High-Risk Prostate Cancer

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
S. Rausch ◽  
C. Schmitt ◽  
T. Kälble
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
High Risk ◽  
Radical Prostatectomy ◽  
Locally Advanced ◽  
Radical Retropubic Prostatectomy ◽  
Cancer Specific Survival ◽  
High Risk Prostate Cancer ◽  
Risk Prostate Cancer

Introduction. High-risk prostate cancer represents a therapeutic challenge. The role of radical prostatectomy (RP) in patients with extreme PSA values is under discussion.Material and Methods. We retrospectively analysed our data of 56 consecutive patients with preoperative PSA ≥ 40 mg/mL undergoing open radical retropubic prostatectomy from 1999 to 2009. Patient survival and time to PSA recurrence were recorded, and the Kaplan-Meier survival analysis was performed. Postoperative quality of life and functional status were investigated using a SF-12 questionnaire and determining the number of pads used per day.Results. Overall 56 patients were available for followup after a median time of 83.84 months. Locally advanced carcinoma was present in 84% while 16% of patients had organ-confined stages. A positive nodal status was observed in 46%. Overall survival was 95% at five and 81% at 10 years. Cancer-specific survival was 100% for five years and 83% for 10 years. Corresponding biochemical recurrence-free survival was low (52% and 11%, resp.). Quality of life and functional outcomes were favourable.Conclusions. In patients with PSA ≥ 40 mg/mL, RP allows long-term control, exact planning of adjuvant treatment, and identification of curable disease.

Quality of life in intermediate or high risk prostate cancer patients treated by 3-D external beam radiotherapy and brachytherapy with or without androgen deprivation

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 14587-14587
Author(s):  
B. Guix ◽  
T. M. Lacorte ◽  
F. Guedea
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
High Risk ◽  
Sexual Function ◽  
External Beam Radiotherapy ◽  
External Beam ◽  
High Risk Prostate Cancer ◽  
Risk Prostate Cancer

14587 Background: To elucidate long-term changes in health-related quality-of-life (HRQOL) outcomes by prospectively re-evaluating a cohort of intermediate- or high-risk prostate cancer patients treated by a combination of 3-D External Beam Radiotherapy (EBRT) and Brachytherapy (BT) with or without androgen deprivation (AD). Methods: A cross-sectional survey was administered to 200 consecutive patients with intermediate (Gleason 7 or PSA 10–20 or T2A-B) or high (Gleason >7 and/or PSA >20 and/or >T2B) - Risk Prostate cancer who were treated by EBRT to the prostate followed by BT to the prostate given either by permanent 125-I seeds (LDR) or high dose rate (HDR) implants before treatment and at 6 months interval during 4 years follow-up. The EORTC CLQ-C30 with the PR-25 module was employed. HRQOL was compared among therapy groups. Comparisons between therapy groups was performed using regression models to control covariates. HRQOL of treatment parameters were evaluated. Distribution of responses for bowel-, urinary- and sexual-related functions were analyzed. Results: 200 patients completed the questionnaires. Significant changes in HRQOL were found depending of the time after treatment. After a temporal decline in HRQOL, an improvement owas found during the first 18 months after end of treatment. Significant improvement in the urinary irritative-obstructive performance (p < 0.006) was found after 6 months post-treatment. Bowel domains worsened after therapies (p < 0,05) but improved after 18 months follow-up (p < 0.02). Overall sexual HRQOL deteriorated depending greatly on treatment (p < 0.008). Patients who were given AD presented a significant lower Sexual Function values, that were difficult to recover after AD cessation (p < 0.007). No differences in HRQOL were found between LDR or HDR BT implants. Satisfaction with either treatment was high. Conclusions: After a decline in HRQOL after treatment, it recovered fully during follow-up. In patients treated by AD, sexual function was the most adversely affected quality-of-life domain. Sexual impairment induced by AD was difficult to recover. These results may be of assistance to men and to clinicians when making treatment decisions, mainly relating AD. No significant financial relationships to disclose.

Radical retropubic prostatectomy in patients with high risk prostate cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 15549-15549
Author(s):  
E. Özgür ◽  
C. Ohlmann ◽  
D. Pfister ◽  
U. Engelmann ◽  
A. Heidenreich
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Gleason Score ◽  
Serum Levels ◽  
Radical Retropubic Prostatectomy ◽  
Cancer Specific Survival ◽  
High Risk Prostate Cancer ◽  
Risk Prostate Cancer ◽  
Psa Recurrence ◽  
Biopsy Gleason Score

15549 Background: Patients with high risk prostate cancer (Gleason score 8 to 10, cT3 disease or PSA > 20 ng/ml) are at high for cancer recurrence after local therapy such as radical retropubic prostatectomy (RPE) or radiation therapy. We examined the long-term oncological and functional outcome of patients with high risk prostate cancer (PCA) on biopsy. We further investigated prognostic risk factors associated with good prognosis. Methods: We retrospectively analysed the outcome of 304 patients with high risk PCA. All patients received a questionnaire to obtain information with regard to continence, potency, PSA recurrence, PSA mortality and quality of life (EORTC QLQ-30). 237 (78%) patients returned the questionnaires. Results: The mean follow-up is 94 (15–146) months, mean age of all patients is 62.6 (32–78) years. 231 (76%) patients had PSA serum levels of 20–50ng/ml, 62 (23.4%) and 39 (12.8%) had PSA serum levels of 50–100 ng/ml and > 100 ng/ml, resp., a pT3 PCA was identified in 192 (63.1%) patients, pTxpN1 disease was found in 84 (27.6%) patients. Overall survival rate is 81.9%, 86.2% and 85.3% in patients with PSA > 20ng/ml, pT3 or pTxpN1 PCA, resp.; cancer specific survival was 85%, 89.5% and 88.7% in PSA > 20ng/ml, pT3 and pTxpN1 PCA, resp. PSA recurrence rate is 28%; the most significant parameters associated with survival are biopsy Gleason score (p = 0.02), pN1 status (p = 0.001), perineural invasion (p = 0.001), seminal vesicle invasion (p < 0.0005). There was no significant difference with regard to pre- and postoperative quality of life. Continence was good with no pads in 85%, 1- 2 pads/day and = 3 pads/day in 10.6% and 4.4%, resp. Conclusions: RPE can be safely performed in patients with high risk PCA resulting in a high cancer specific survival rate. Most suitable candidates are patients with biopsy Gleason score < 8, pN0 and = pT3a; even in cT3 PCA RPE is a valuable therapeutic option with long-term PCA-free survival and might be considered in men with a long life expectancy. No significant financial relationships to disclose.

Sign in / Sign up

Export Citation Format

Share Document