Long-Term Outcomes After Prostate Surgery for High-Risk Cancer
Author Information
Author(s): Dan Lewinshtein, Brandon Teng, Ashley Gibbons, Robert Porter, Christopher R.
Primary Institution: Virginia Mason Medical Center
Hypothesis
Patients with pathologic Gleason 8–10 disease may have better long-term clinical outcomes after radical prostatectomy than previously thought.
Conclusion
Cancer control is durable even 10 years after surgery in patients with pathologic Gleason 8–10 disease.
Supporting Evidence
- 68.9% of patients had stage T3 disease or higher.
- 52.7% of patients had a positive surgical margin.
- Only 6% of patients died of their disease after 10 years.
Takeaway
This study looked at men with serious prostate cancer who had surgery, and found that most of them lived a long time without their cancer coming back.
Methodology
Retrospective analysis of charts from patients who underwent radical prostatectomy between 1988 and 1997, with follow-up data collected.
Potential Biases
Postoperative treatment decisions were made at the discretion of the treating physician, potentially introducing bias.
Limitations
Data derived from a single center over 20 years with multiple surgeons, which may have introduced variation in outcomes.
Participant Demographics
Median age was 65 years, with a median PSA of 9.7 ng/ml; 68.9% had stage T3 disease or higher.
Statistical Information
Confidence Interval
CI: 53%–65% for BCR-free survival, CI: 84%–92% for mets-free survival, CI: 91%–97% for PCSS.
Digital Object Identifier (DOI)
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