Natural History Of Pathologically Organ-Confined (pT2), Gleason Score 6 Or Less, Prostate Cancer After Radical Prostatectomy

Main Category: Prostate / Prostate Cancer
Also Included In: Urology / Nephrology;  Clinical Trials / Drug Trials
Article Date: 03 May 2008 - 0:00 PDT

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UroToday.com - According to a report from Dr. Hernandez and colleagues at Johns Hopkins University that appears in the online version of Urology, men with prostate cancer (CaP) who undergo radical prostatectomy (RP) and have organ confined disease with Gleason score 6 or less are very unlikely to experience disease recurrence.

A retrospective review identified 2,526 men between 1983 and 2005 who underwent RP, either open (2,422) or laparoscopic (104). All had pathologic organ confined disease and Gleason score 6 or less cancer. Median age was 58 years, and median preoperative PSA was 5.2ng/ml. Almost 72% had cT1c disease. A total of 52% had 5 years or more of follow-up and 18% had more than 10 years follow-up. A local recurrence was identified in 5 men and 4 of these had salvage radiotherapy. No patient developed distant metastasis. Death from other caused occurred in 77 patients (3%) and no prostate cancer specific mortality occurred. The Kaplan-Meier survival analysis for actuarial probability of biochemical recurrence at 5, 10, and 15 years was 0.3%, 0.9%, and 1.3%, respectively. The 5, 10, and 15 year actuarial probability of local recurrence was 0.1%, 0.5%, and 0.5%, respectively.

The authors were not able to determine which men had "insignificant cancer" based upon RP tumor volume, but by applying PSA and needle biopsy data they identified 268 men (10.6%) who had insignificant tumors at RP. The oncologic outcomes for organ-confined low risk CaP in this series are excellent.

Reported by UroToday.com Contributing Editor Christopher P. Evans, MD, FACS

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