Prognosis of Patients with Stage D1 Prostate Carcinoma Following Radical Prostatectomy with and Without Early Endocrine Therapy

Abstract

Early endocrine therapy after radical retropubic prostatectomy was compared to radical prostatectomy alone (nonearly endocrine therapy) for the treatment of carcinoma of the prostate with lymph node metastases. Our retrospective analysis demonstrated that the 2 cohorts were similar with respect to patient age, Gleason sum score, seminal vesicle invasion, lymph node involvement, tumor volume and pathological stage of the primary tumor. The cause-specific survival of the entire group was 84% at 60 months and 78% at 98 months. The cause-specific curves for the early and nonearly endocrine therapy group were not significantly different (p less than 0.194), although the estimated 9-year survival rates were 91 and 71%, respectively. Survival free of disease was significantly prolonged in the early endocrine therapy group (p less than 0.030), with a 9-year estimated rate free of disease of 67% versus 32% in the nonearly endocrine therapy group. Followup prostate specific antigen serum levels were analyzed and the value as a progression marker is discussed. These data suggest that a radical operation plus early endocrine therapy is effective palliation in selected patients with low volume lymph node metastases, producing clinical survival free of disease in most patients.

Significance of androgen deprivation prior to radical prostatectomy, with special reference to prostate-specific antigen

“…Some investigators suggest early endocrine therapy for patients with positive margins or lymph-node metastasis [15,23]. The follow-up period is too short for a comment on the survival benefits of this combined approach.…”

Half-Life of Prostate-Specific Antigen after Radical Prostatectomy: The Decisive Predictor of Curative Treatment?

“…Experience with radical prostatectomies shows that persistent disease is a common problem after surgery [7,11,19,23,24], The decision for adjuvant treatment was based mainly on unfavorable pathological findings (i.e., positive surgical margins). Increasing experience with PSA suggests that residual disease can be identified reli ably on the basis of increased PSA levels [13][14][15][16][17][18][19].…”

Nucleolar organizer regions in low- and high-grade carcinomas of the prostate

“…Our AgNOR analysis as well as previous cell kinetics studies and DNA cytometry findings and the present nucleolar subgrading likewise support the idea that patients with cancer of the prostate have to be dividied in two groups; one with low risk and the other with high risk. As reported in the literature, the 10-year survival of the low-risk group is 60%-70% and that of the high-risk group is 20%-30% [21].…”