PSA outcome following radical prostatectomy for patients with localized prostate cancer stratified by prostatectomy findings and the preoperative PSA level

McAleer, S.; Schultz, Delray; Whittington, Richard; Malkowicz, S. Bruce; Renshaw, Andrew A.; Wein, Alan J.; Richie, Jerome P.; D’Amico, Anthony V.

doi:10.1016/j.urolonc.2004.12.013

Cited by 19 publications

(11 citation statements)

References 23 publications

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“…In one (29) with 106 SV positive patients, with a median follow up of 43 months, for Gleason 2-6, 40% failed; Gleason 7, 47%; and Gleason 8-10, 58%. Another (19) found that Gleason 8-10 and SV+ patients had a very high 7 year failure rate (72%), which was slightly improved if the PSA was < 10 ng/ml (63%) versus >10 ng/ml (86%).…”

Section: Seminal Vesicle and Lymph Node Positivementioning

confidence: 99%

“…In clinical trial design, some have designated patients as high risk of recurrence (warranting neoadjuvant chemotherapy) if the nomogram predicted risk of failure was >40% by 5 years (18). Others have proposed that patients with a biochemical failure rate of 25-35% are appropriate candidates for adjuvant local therapy (19). Given that, we would argue that our threshold is reasonable and that patients with < 50% 5 year biochemical control have a high enough risk of metastasis and death to warrant serious consideration of adjuvant treatment.…”

Section: Risk Warranting Interventionmentioning

confidence: 99%

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Prognostic Factors for Failure after Prostatectomy

Swanson¹,

Basler²

2011

J. Cancer

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Section: Seminal Vesicle and Lymph Node Positivementioning

confidence: 99%

Section: Risk Warranting Interventionmentioning

confidence: 99%

Prognostic Factors for Failure after Prostatectomy

Swanson¹,

Basler²

2011

J. Cancer

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“…7,8 In addition to the pre-operative serum PSA, Gleason score on pathology specimen, the seminal vesicle invasion and lymph node status, and a positive surgical margin with extraprostatic extension (EPE) are significant predictors of clinical and biochemical recurrence (BCR). [9][10][11][12][13] However, the prognostic implication of capsular incision (CI), tumor extending to the inked margins without a histologically documented EPE, remains to be defined. Most of the earlier studies evaluated the retropubic approach.…”

Section: Introductionmentioning

confidence: 99%

Impact of capsular incision on biochemical recurrence after radical perineal prostatectomy

Kwak

Lee

Choi

2009

Prostate Cancer Prostatic Dis

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The prognostic implications of capsular incision (CI) remain to be defined. We evaluated the impact of CI on biochemical recurrence (BCR) and the potential risk factors of CI. Between June 1995 and July 2007, 266 patients with follow-up for at least 6 months, who had neither the seminal vesicle nor lymph node involvement on prostatectomy specimen, were included. Patients with insufficient biopsy data and those with neoadjuvant and/or adjuvant therapy were excluded. CI was defined as tumor extending into the inked margins, at sites except the apex of the prostate, without documented extraprostatic extension (EPE). There were 186 with organ-confined disease and negative surgical margins (pT2/SM-), 12 with organ-confined disease and an apex-only positive margin (pT2/AM þ ), 35 with CI, 19 with EPE and negative surgical margins (pT3a/SM-) and 13 with EPE and positive surgical margins (pT3a/SM þ ). We compared BCR-free probability among these five groups and the risk factors for CI were assessed. The 3-year BCR-free probability for each group was 92.7% for pT2/SM-, 75.8% for pT2/AM þ , 70.7% with CI, 84% with pT3/SM-and 51% in pT3/SM þ . That for CI was worse than pT2/SM-(P ¼ 0.007), not significantly different from pT2/AM þ and pT3/SM-(P ¼ 0.614, P ¼ 0.318, respectively), but better than pT3/SM þ (P ¼ 0.044), adjusting for the pre-operative prostate-specific antigen and pathological Gleason score. The risk for CI was significantly associated with more than 25% positive biopsy cores. CI seems to affect BCR and is more likely to occur in proportion to positive biopsy cores.

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“…At present, a greater percentage of men might have T1c disease, but in the present study patients had RP between 1993 and 2002. In the USA, the proportion of T1c was 48.3% of the 2417 cases in 1988–2002 [15] and 63% of the 5079 cases in 1994–2000 [16]. Therefore, there were no significant differences in the staging of the patients between those in Japan and in the USA, which probably did not affect the study outcome.…”

Section: Discussionmentioning

confidence: 99%

Percentage of positive biopsy cores, preoperative prostate‐specific antigen (PSA) level, pT and Gleason score as predictors of PSA recurrence after radical prostatectomy: a multi‐institutional outcome study in Japan

Yokomizo¹,

Murai

Baba

et al. 2006

BJU International

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were collected from the Urological Oncology Study Group, a subgroup of Japan Clinical Oncology Group. RESULTSThe patients' median (range) age was 67 (47-83) years and their PSA level before RP was 8.7 (1.0-153) ng/mL. During the median follow-up of 45.6 months, 302 of the 1192 patients (25.3%) developed PSA recurrence. The median time to recurrence was 369 (61-2128) days after RP. A log-rank test showed that five significant clinicopathological factors were associated with PSA recurrence after RP: The percentage of prostate needle-biopsy cores with cancer, the biopsy Gleason score, PSA level before RP, pathological stage, and the Gleason score of the RP specimen ( P < 0.001 for all). In multivariate analyses, the percentage of positive biopsy cores, PSA level before RP, pT and the Gleason score of the RP specimen were all independent significant predictors of PSA recurrence after RP in Japanese men. CONCLUSIONSThe frequency of PSA recurrence after RP was 25.3% in Japan and the percentage of positive biopsy cores, PSA level before RP, pT and the Gleason score of the RP specimen were independent significant factors for PSA recurrence.

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PSA outcome following radical prostatectomy for patients with localized prostate cancer stratified by prostatectomy findings and the preoperative PSA level

Cited by 19 publications

References 23 publications

Prognostic Factors for Failure after Prostatectomy

Prognostic Factors for Failure after Prostatectomy

Impact of capsular incision on biochemical recurrence after radical perineal prostatectomy

Percentage of positive biopsy cores, preoperative prostate‐specific antigen (PSA) level, pT and Gleason score as predictors of PSA recurrence after radical prostatectomy: a multi‐institutional outcome study in Japan

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