Long-term outcomes of radical prostatectomy with multimodal adjuvant therapy in men with a preoperative serum prostate-specific antigen level ≥50 ng/mL

Brant A. Inman, Judson D. Davies, Laureano J. Rangel, Eric J. Bergstralh, Eugene D Kwon, Michael L. Blute, Robert Jeffrey Karnes, Bradley C. Leibovich

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

BACKGROUND. The authors evaluated the long-term outcomes of men with prostate cancer and very high (≥50 ng/mL) preoperative serum prostate-specific antigen (PSA) values that were treated with radical prostatectomy. METHODS. This study included 236 men with preoperative serum PSA values ≥50 ng/mL who underwent radical retropubic prostatectomy between 1987 and 2004. For comparison, the study cohort was divided into 2 groups: patients with PSA levels between 50 and 99 ng/mL and patients with PSA levels ≥100 ng/mL. Biochemical recurrence was defined as a single postoperative serum PSA value of 0.4 ng/mL or greater. Systemic disease progression was defined as the development of a local recurrence or systemic metastases, and any death resulting from prostate cancer or its treatment was defined as a cancer-specific mortality. RESULTS. Biochemical recurrence-free survival rates in the groups of patients with a PSA level 50 to 99 ng/mL and ≥100 ng/mL were 43% and 36% at 10 years, respectively. Systemic progression-free survival rates in the PSA 50 to 99 ng/mL and PSA ≥100 ng/mL groups were 83% and 74% at 10 years, respectively. Estimated overall cancer-specific survival was 87% at 10 years. CONCLUSIONS. Patients with prostate cancer and a serum PSA level ≥50 ng/mL have very high-risk prostate cancer that carries a high likelihood of being pathologically advanced. Although the probability of realizing long-term survival in these high-risk patients is less than in patients with more favorable disease, 10-year survival outcomes remain excellent and argue for aggressive management of these cases.

Original languageEnglish (US)
Pages (from-to)1544-1551
Number of pages8
JournalCancer
Volume113
Issue number7
DOIs
StatePublished - Oct 1 2008

Fingerprint

Prostate-Specific Antigen
Prostatectomy
Serum
Prostatic Neoplasms
Therapeutics
Recurrence
Survival
Survival Rate
Case Management
Disease-Free Survival
Disease Progression
Neoplasms
Cohort Studies
Neoplasm Metastasis
Mortality

Keywords

  • Androgen deprivation therapy
  • External beam radiotherapy
  • Prostate cancer
  • Prostate-specific antigen
  • Radical prostatectomy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Long-term outcomes of radical prostatectomy with multimodal adjuvant therapy in men with a preoperative serum prostate-specific antigen level ≥50 ng/mL. / Inman, Brant A.; Davies, Judson D.; Rangel, Laureano J.; Bergstralh, Eric J.; Kwon, Eugene D; Blute, Michael L.; Karnes, Robert Jeffrey; Leibovich, Bradley C.

In: Cancer, Vol. 113, No. 7, 01.10.2008, p. 1544-1551.

Research output: Contribution to journalArticle

Inman, Brant A. ; Davies, Judson D. ; Rangel, Laureano J. ; Bergstralh, Eric J. ; Kwon, Eugene D ; Blute, Michael L. ; Karnes, Robert Jeffrey ; Leibovich, Bradley C. / Long-term outcomes of radical prostatectomy with multimodal adjuvant therapy in men with a preoperative serum prostate-specific antigen level ≥50 ng/mL. In: Cancer. 2008 ; Vol. 113, No. 7. pp. 1544-1551.
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abstract = "BACKGROUND. The authors evaluated the long-term outcomes of men with prostate cancer and very high (≥50 ng/mL) preoperative serum prostate-specific antigen (PSA) values that were treated with radical prostatectomy. METHODS. This study included 236 men with preoperative serum PSA values ≥50 ng/mL who underwent radical retropubic prostatectomy between 1987 and 2004. For comparison, the study cohort was divided into 2 groups: patients with PSA levels between 50 and 99 ng/mL and patients with PSA levels ≥100 ng/mL. Biochemical recurrence was defined as a single postoperative serum PSA value of 0.4 ng/mL or greater. Systemic disease progression was defined as the development of a local recurrence or systemic metastases, and any death resulting from prostate cancer or its treatment was defined as a cancer-specific mortality. RESULTS. Biochemical recurrence-free survival rates in the groups of patients with a PSA level 50 to 99 ng/mL and ≥100 ng/mL were 43{\%} and 36{\%} at 10 years, respectively. Systemic progression-free survival rates in the PSA 50 to 99 ng/mL and PSA ≥100 ng/mL groups were 83{\%} and 74{\%} at 10 years, respectively. Estimated overall cancer-specific survival was 87{\%} at 10 years. CONCLUSIONS. Patients with prostate cancer and a serum PSA level ≥50 ng/mL have very high-risk prostate cancer that carries a high likelihood of being pathologically advanced. Although the probability of realizing long-term survival in these high-risk patients is less than in patients with more favorable disease, 10-year survival outcomes remain excellent and argue for aggressive management of these cases.",
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T1 - Long-term outcomes of radical prostatectomy with multimodal adjuvant therapy in men with a preoperative serum prostate-specific antigen level ≥50 ng/mL

AU - Inman, Brant A.

AU - Davies, Judson D.

AU - Rangel, Laureano J.

AU - Bergstralh, Eric J.

AU - Kwon, Eugene D

AU - Blute, Michael L.

AU - Karnes, Robert Jeffrey

AU - Leibovich, Bradley C.

PY - 2008/10/1

Y1 - 2008/10/1

N2 - BACKGROUND. The authors evaluated the long-term outcomes of men with prostate cancer and very high (≥50 ng/mL) preoperative serum prostate-specific antigen (PSA) values that were treated with radical prostatectomy. METHODS. This study included 236 men with preoperative serum PSA values ≥50 ng/mL who underwent radical retropubic prostatectomy between 1987 and 2004. For comparison, the study cohort was divided into 2 groups: patients with PSA levels between 50 and 99 ng/mL and patients with PSA levels ≥100 ng/mL. Biochemical recurrence was defined as a single postoperative serum PSA value of 0.4 ng/mL or greater. Systemic disease progression was defined as the development of a local recurrence or systemic metastases, and any death resulting from prostate cancer or its treatment was defined as a cancer-specific mortality. RESULTS. Biochemical recurrence-free survival rates in the groups of patients with a PSA level 50 to 99 ng/mL and ≥100 ng/mL were 43% and 36% at 10 years, respectively. Systemic progression-free survival rates in the PSA 50 to 99 ng/mL and PSA ≥100 ng/mL groups were 83% and 74% at 10 years, respectively. Estimated overall cancer-specific survival was 87% at 10 years. CONCLUSIONS. Patients with prostate cancer and a serum PSA level ≥50 ng/mL have very high-risk prostate cancer that carries a high likelihood of being pathologically advanced. Although the probability of realizing long-term survival in these high-risk patients is less than in patients with more favorable disease, 10-year survival outcomes remain excellent and argue for aggressive management of these cases.

AB - BACKGROUND. The authors evaluated the long-term outcomes of men with prostate cancer and very high (≥50 ng/mL) preoperative serum prostate-specific antigen (PSA) values that were treated with radical prostatectomy. METHODS. This study included 236 men with preoperative serum PSA values ≥50 ng/mL who underwent radical retropubic prostatectomy between 1987 and 2004. For comparison, the study cohort was divided into 2 groups: patients with PSA levels between 50 and 99 ng/mL and patients with PSA levels ≥100 ng/mL. Biochemical recurrence was defined as a single postoperative serum PSA value of 0.4 ng/mL or greater. Systemic disease progression was defined as the development of a local recurrence or systemic metastases, and any death resulting from prostate cancer or its treatment was defined as a cancer-specific mortality. RESULTS. Biochemical recurrence-free survival rates in the groups of patients with a PSA level 50 to 99 ng/mL and ≥100 ng/mL were 43% and 36% at 10 years, respectively. Systemic progression-free survival rates in the PSA 50 to 99 ng/mL and PSA ≥100 ng/mL groups were 83% and 74% at 10 years, respectively. Estimated overall cancer-specific survival was 87% at 10 years. CONCLUSIONS. Patients with prostate cancer and a serum PSA level ≥50 ng/mL have very high-risk prostate cancer that carries a high likelihood of being pathologically advanced. Although the probability of realizing long-term survival in these high-risk patients is less than in patients with more favorable disease, 10-year survival outcomes remain excellent and argue for aggressive management of these cases.

KW - Androgen deprivation therapy

KW - External beam radiotherapy

KW - Prostate cancer

KW - Prostate-specific antigen

KW - Radical prostatectomy

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DO - 10.1002/cncr.23767

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JO - Cancer

JF - Cancer

SN - 0008-543X

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