Radical prostatectomy outcome when performed with PSA above 20 ng/ml.
Affiliation
Department of Urology, St Vincent's University Hospital, Elm Park, Dublin 4., stephensconnolly@gmail.comIssue Date
2012-02-01T10:31:36ZMeSH
AgedHumans
Male
Middle Aged
Prostate-Specific Antigen/*blood
*Prostatectomy
Prostatic Neoplasms/blood/mortality/*surgery
Survival Rate
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Ir Med J. 2011 Apr;104(4):108-11.Journal
Irish medical journalPubMed ID
21675092Abstract
Many centres currently do not offer radical prostatectomy (RP) to men with high-risk localised prostate cancer due to concerns regarding poor outcome, despite evidence to the contrary. We identified 18 men undergoing RP with serum PSA >20 ng/ml (high-risk by National Comprehensive Cancer Network definition) and minimum follow-up of 12 years (mean 13.5). Mean preoperative PSA was 37.0 ng/ml (Range 21.1-94.0). Prostatectomy pathology reported extracapsular disease in 16 (88.9%), positive surgical margins in 15 (83%) and positive pelvic lymph nodes in 5 (27.8%). Overall and cancer-specific survival at 5 and 10-years was 83.3%, 88.2%, 72% and 76.5% respectively. With complete follow-up 11 (61.1%) are alive, and 5 (27.8%) avoided any adjuvant therapy. Complete continence (defined as no involuntary urine leakage and no use of pads) was achieved in 60%, with partial continence in the remainder. We conclude that surgery for this aggressive variant of localised prostate cancer can result in satisfactory outcome.Language
engISSN
0332-3102 (Print)0332-3102 (Linking)
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