Localized prostate cancer

Ohori, Makoto; Scardino, Peter T.

doi:10.1067/msg.2002.126335

Cited by 35 publications

(25 citation statements)

References 223 publications

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“…The procedures were performed by experienced surgeons using the standard described technique. 15 Briefly, a bilateral pelvic lymph node dissection was performed. The prostate was then mobilized, the dorsal vascular complex was divided, and sutures were ligated.…”

Section: Surgical Technique and Specimen Processingmentioning

confidence: 99%

Cancer‐specific survival and predictors of prostate‐specific antigen recurrence and survival in patients with seminal vesicle invasion after radical prostatectomy

Secín

Bianco

Vickers

et al. 2006

Cancer

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BACKGROUNDThe objectives of the current study were to determine the long‐term biochemical recurrence (BCR) and cancer‐specific survival (CSS) rates for men with seminal vesicle invasion (SVI) and to identify risk factors for freedom from BCR and CSS in patients who received treatment in the prostate‐specific antigen era and who had SVI identified at the time of radical prostatectomy (RP).METHODSProspective clinical, pathologic, and outcome data were collected for 5377 men who underwent RP between June 1983 and August 2004. There were 936 patients who were excluded because they received treatment before RP. Multivariable analysis was used to identify the factors that predicted BCR and CSS.RESULTSAmong 4441 eligible patients, 387 patients (8.7%) had SVI, and 91 of those 387 patients (24%) had lymph node involvement (LNI). In total, 210 patients experienced BCR. For patients without LNI, the 10‐year and 15‐year freedom from BCR rates were 36% and 32%, respectively, and the corresponding CSS rates were 89% and 81%, respectively. For the 91 men who had SVI and LNI, the 10‐year BCR‐free probability was 10%, but the 10‐year CSS probability was 74%. By 10 years, patients with LNI were 3 times more likely to die from cancer than from other causes; nonetheless, 66% of patients were alive despite their advanced stage. The preoperative prostate‐specific antigen level, extracapsular extension, LNI, and Gleason grade were associated independently with BCR. Gleason scores of 8 to 10 and LNI were significant predictors of CSS.CONCLUSIONSSVI does not invariably signal BCR or death from cancer in patients who undergo RP and pelvic lymph node dissection. Fifteen years later, approximately 33% of men with SVI and negative lymph nodes are expected remain free of BCR, and CSS was surprisingly good. Cancer 2006. © 2006 American Cancer Society.

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Section: Surgical Technique and Specimen Processingmentioning

confidence: 99%

Cancer‐specific survival and predictors of prostate‐specific antigen recurrence and survival in patients with seminal vesicle invasion after radical prostatectomy

Secín

Bianco

Vickers

et al. 2006

Cancer

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“…Care must be taken to preserve Denonvillier's fascia over the posterior prostate in order to reduce the risk of positive surgical margins (PSM). 13,14 the incision of the lateral pelvic fascia along the longitudinal axis of the prostate begins at a level well medial to the neurovascular bundles. The bundles are then swept inferiorly and laterally from the prostate and then sharply dissected free from the prostate from apex to base.…”

Section: The Ruckle and Zincke 8 Technique This Techniquementioning

confidence: 99%

“…The Scardino technique 13,14 In this technique, following the transection of the dorsal complex, the lateral pelvic fascia is incised medial to the neurovascular bundle on the anterolateral prostatic portion and the bundles are gently swept laterally from the prostate. A lateral retraction of the bundle allows the Denonvillier fascia to be exposed.…”

Section: The Ruckle and Zincke 8 Technique This Techniquementioning

confidence: 99%

Nerve-sparing radical retropubic prostatectomy: techniques and clinical considerations

Gontero

Kirby

2005

Prostate Cancer Prostatic Dis

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There are essentially two ways to accomplish nerve preservation during radical retropubic prostatectomy: the 'apical approach' described by Walsh and the so-called 'lateral approach', a simplified method where the dissection is initially conducted on the portion of the bundles that courses posterolateral to the prostate. Do the different techniques differ in the ability to preserve potency and in the positive surgical margins rate? No previous study has addressed this question. Above all, the preoperative and intraoperative indications to spare or not the nerves remain a matter of debate. The present review is an attempt to elucidate these questions in light of the current literature.

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“…Furthermore, treatments for early cancer have been well organized in the last two decades so that patients have many treatments options [1]. While many investigators have been trying to develop prognostic markers or statistical models [2]- [5], the risk groups reported by D'Amico et al [6] and the National Comprehensive Cancer Network (NCCN) guidelines [7] are simple to use, easy to understand by patients, and readily applied by physicians in the clinic.…”

Section: Introductionmentioning

confidence: 99%

“…With the advent of serum prostate-specific antigen (PSA), prostate cancers can be detected early on; however, difficulty in detecting clinically non-significant disease still exists [1]. Furthermore, treatments for early cancer have been well organized in the last two decades so that patients have many treatments options [1].…”

Section: Introductionmentioning

confidence: 99%

Pathologic and Prognostic Outcomes of Very Low- and Low-Risk Prostate Cancer According to the National Comprehensive Cancer Network Guidelines in Japanese Patients with Radical Prostatectomy

Takizawa¹,

Ohori²,

Ohno³

et al. 2016

JCT

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Background: The purpose of this study was to validate the treatment strategy for a cohort of Japanese patients with very low-risk (VLR) and low-risk (LR) prostate cancer according to the National Comprehensive Cancer Network (NCCN) guidelines. Methods: We studied 751 patients with T1-3N0M0 prostate cancer treated with radical prostatectomy at our institution between 2000 and 2012. Patients with neoadjuvant treatments were excluded. We retrospectively reviewed the clinical and pathological outcomes for patients with VLR or LR prostate cancers that were classified by NCCN guidelines. Results: We identified 45 patients with VLR and 137 with LR prostate cancer. Non-biochemical recurrence rate at 5-year for 45 patients with VLR was 86.9% and 81.2% for 137 patients with LR (p = 0.56). However, none of the 19 patients >65 years old with VLR progressed, while 19% of 26 patients ≤65 years old with VLR cancer, 14% of patients >65 years old with LR cancer, and 17% of patients ≤65 years old with LR cancer progressed during the follow-up period (p = 0.04, p = 0.04 and p = 0.05, respectively). In analyses of prostatectomy specimens, both VLR and LR had similarly favorable outcomes, but patients >65 years old with VLR had the smallest tumors, with a mean of 5 mm in diameter. Conclusions: Our results support the treatment strategy of the NCCN that patients with VLR cancer and age >65 years old are good candidates for active surveillance, and that other treatment options-including active surveillance and aggressive treatments-can be applied to the remaining patients with VLR or LR cancers.

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Localized prostate cancer

Cited by 35 publications

References 223 publications

Cancer‐specific survival and predictors of prostate‐specific antigen recurrence and survival in patients with seminal vesicle invasion after radical prostatectomy

Cancer‐specific survival and predictors of prostate‐specific antigen recurrence and survival in patients with seminal vesicle invasion after radical prostatectomy

Nerve-sparing radical retropubic prostatectomy: techniques and clinical considerations

Pathologic and Prognostic Outcomes of Very Low- and Low-Risk Prostate Cancer According to the National Comprehensive Cancer Network Guidelines in Japanese Patients with Radical Prostatectomy

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