Radical Prostatectomy Can Provide a Cure For Well&amp;ndash;Selected Clinical Stage T3 Prostate Cancer

Poppel, Hendrik Van; Goethuys, H; Callewaert, P.; Vanuytsel, L.; Voorde, Wim Van de; Baert, Luc

doi:10.1159/000020311

Cited by 93 publications

(48 citation statements)

References 22 publications

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“…We have not discussed the possibility of a therapeutic role of lymphadenectomy here [11,12] , however since 35% of our patients with clinical T3 disease had lymph node-positive disease, these patients might obtain improved survival from the procedure itself, and identification of pN+ disease is a correct indication for adjuvant therapy. As highlighted by previous studies [13] and by the present study, T3 PCa confirmed its high risk of lymph node involvement.…”

Section: Discussionsupporting

confidence: 89%

Outcomes of Radical Prostatectomy in Clinically Locally Advanced N0M0 Prostate Cancer

Mearini

Zucchi²,

Costantini³

et al. 2010

Urol Int

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Introduction: Radical prostatectomy (RP) in patients with locally advanced (cT3) prostate cancer (PCa) is considered an optional therapy. Aim: To evaluate outcomes of surgery for cT3 disease and to compare results with those of patients treated for cT1–T2 PCa. Patients and Methods: Data of 74 consecutive patients with cT3 N0M0 PCa who underwent RP were compared to those of 425 consecutive unselected patients who underwent surgery for cT1–T2 N0M0 disease. Results: cT3: The pathological report showed a pathological downstaging in 16.3% of cases. Continence rate was 65.5%, potency rate was 38.8%, 5-year PSA-free survival was 61.9%, 5-year cancer-specific survival was 95.2%. cT1–T2: The pathological report showed a clinical downstaging in 39.1%. Continence rate was 70.8%, potency rate was 56.2%, 5-year PSA-free survival was 67.4%, 5-year cancer-specific survival was 96.0%. Conclusions: cT3 PCa presents challenges for the uro-oncologist since standard treatment is still under debate. RP in well-informed patients is a procedure with acceptable morbidity and should be at least a first part of a multimodality approach.

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Section: Discussionsupporting

confidence: 89%

Outcomes of Radical Prostatectomy in Clinically Locally Advanced N0M0 Prostate Cancer

Mearini

Zucchi²,

Costantini³

et al. 2010

Urol Int

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“…Increased overall surgical experience has certainly favoured the decreased operative morbidity rate from radical prostatectomy for clinical T3 cancer patients [129]. Reports on treatment outcomes in patients with clinical T3 cancer are currently available [129][130][131][132][133][134][135][136]. A recently published ECOG study in 98 node positive patients randomized to early versus deferred hormonetherapy reported an increased 5-year overall survival.…”

Section: Surgery Plus Hormone-therapymentioning

confidence: 99%

Cancer of the prostate

Bracarda

Cobelli

Greco

et al. 2005

Critical Reviews in Oncology/Hematology

102

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“…The only exception, with a markedly lower rate of pN+ cases, is the series reported by van Poppel et al [14] with only 11%, perhaps due to a highly selected cohort. The risk of nodal spread in cT3 disease is, as in T2 disease, correlated with Gleason score, PSA value and possible seminal vesicle invasion.…”

Section: Staging Of Ct3 Diseasementioning

confidence: 87%

“…Radical prostatectomy in cT3 disease results in incomplete tumor removal (R1) in 22-60% of cases [6,14,19] , and up to 48% of patients will have lymph node disease. Thus, it can be argued that for these patients surgery does not achieve a great deal while potentially incurring significant morbidity.…”

Section: Radical Prostatectomy In Ct3 Diseasementioning

confidence: 99%

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Treatment of Locally Advanced Prostate Cancer – The Case for Radical Prostatectomy

Hakenberg¹,

Fröhner²,

Wirth³

2006

Urol Int

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The treatment of clinically locally advanced prostate carcinoma (stage cT3) remains controversial. One of the main reasons for this controversy results from the substantial staging error attached to the clinical diagnosis cT3 with overstaged T2 tumors and understaged node-positive cases. Treatment options in this situation include radical prostatectomy, external beam radiotherapy, immediate or delayed androgen deprivation treatment and the so-called ‘watchful waiting’. Acceptable and often surprisingly good tumor-specific survival rates have been reported for radical prostatectomy in pT3 series – based on good clinical case selection – approaching those of pT2 series. In lymph node-positive pT3 cases, adjuvant hormone deprivation seems to prolong survival which it does not in lymph node-negative pT3 disease. A benefit of adjuvant external beam radiotherapy after radical prostatectomy for pT3 cases in prolonging overall survival has not been shown, despite the fact that it can prevent or delay biochemical and local recurrence. External beam radiotherapy as the only treatment for cT3 disease results in unfavorable tumor-specific survival rates, which can be significantly improved with adjuvant hormonal treatment with LHRH agonists. If, in case of advanced age and/or significant comorbidity, primary hormonal treatment is chosen, early hormonal deprivation therapy seems to offer marginal benefits in survival compared to delayed treatment.

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Radical Prostatectomy Can Provide a Cure For Well–Selected Clinical Stage T3 Prostate Cancer

Cited by 93 publications

References 22 publications

Outcomes of Radical Prostatectomy in Clinically Locally Advanced N0M0 Prostate Cancer

Outcomes of Radical Prostatectomy in Clinically Locally Advanced N0M0 Prostate Cancer

Cancer of the prostate

Treatment of Locally Advanced Prostate Cancer – The Case for Radical Prostatectomy

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