Oncological outcomes following radical prostatectomy for patients with pT4 prostate cancer

Dharam Kaushik, Stephen A. Boorjian, R. Houston Thompson, Manuel S. Eisenberg, Rachel E. Carlson, Eric J. Bergstralh, Igor Frank, Matthew T. Gettman, Matthew K. Tollefson, Robert Jeffrey Karnes

Research output: Contribution to journalArticle

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Abstract

Objectives: Radical prostatectomy (RP) for locally advanced prostate cancer may reduce the risk of metastasis and cancer-specific death. Herein, we evaluated the outcomes for patients with pT4 disease treated with RP. Materials and methods: Among 19,800 men treated with RP at Mayo Clinic from 1987 to 2010, 87 were found to have pT4 tumors. Biochemical recurrence (BCR)-free survival, systemic progression (SP) free survival and overall survival (OS) were estimated using the Kaplan-Meier method and compared with the log-rank test. Cox proportional hazards regression models were used to assess the association of clinic-pathological features with outcome. Results: Median follow-up was 9.8 years (IQR 3.6, 13.4). Of the 87 patients, 50 (57.5%) were diagnosed with BCR, 30 (34.5%) developed SP, and 38 (43.7%) died, with 11 (12.6%) dying of prostate cancer. Adjuvant androgen deprivation therapy was administered to 77 men, while 32 received adjuvant external beam radiation therapy. Tenyear BCR-free survival, SP-free survival, and OS was 37%, 64%, and 70% respectively. On multivariate analysis, the presence of positive lymph nodes was marginally significantly associated with patients' risk of BCR (HR: 1.94; p=0.05), while both positive lymph nodes (HR 2.96; p=0.02) and high pathologic Gleason score (HR 1.95; p=0.03) were associated with SP. Conclusions: Patients with pT4 disease may experience long-term survival following RP, and as such, when technically feasible, surgical resection should be considered in the multimodal treatment approach to these men.

Original languageEnglish (US)
Pages (from-to)1091-1098
Number of pages8
JournalInternational Braz J Urol
Volume42
Issue number6
DOIs
StatePublished - 2016

Fingerprint

Prostatectomy
Prostatic Neoplasms
Recurrence
Disease-Free Survival
Survival
Lymph Nodes
Combined Modality Therapy
Neoplasm Grading
Proportional Hazards Models
Androgens
Neoplasms
Radiotherapy
Multivariate Analysis
Neoplasm Metastasis
Therapeutics

Keywords

  • Neoplasm metastasis
  • Prostatectomy
  • Prostatic neoplasms

ASJC Scopus subject areas

  • Urology

Cite this

Kaushik, D., Boorjian, S. A., Thompson, R. H., Eisenberg, M. S., Carlson, R. E., Bergstralh, E. J., ... Karnes, R. J. (2016). Oncological outcomes following radical prostatectomy for patients with pT4 prostate cancer. International Braz J Urol, 42(6), 1091-1098. https://doi.org/10.1590/S1677-5538.IBJU.2016.0290

Oncological outcomes following radical prostatectomy for patients with pT4 prostate cancer. / Kaushik, Dharam; Boorjian, Stephen A.; Thompson, R. Houston; Eisenberg, Manuel S.; Carlson, Rachel E.; Bergstralh, Eric J.; Frank, Igor; Gettman, Matthew T.; Tollefson, Matthew K.; Karnes, Robert Jeffrey.

In: International Braz J Urol, Vol. 42, No. 6, 2016, p. 1091-1098.

Research output: Contribution to journalArticle

Kaushik, D, Boorjian, SA, Thompson, RH, Eisenberg, MS, Carlson, RE, Bergstralh, EJ, Frank, I, Gettman, MT, Tollefson, MK & Karnes, RJ 2016, 'Oncological outcomes following radical prostatectomy for patients with pT4 prostate cancer', International Braz J Urol, vol. 42, no. 6, pp. 1091-1098. https://doi.org/10.1590/S1677-5538.IBJU.2016.0290
Kaushik D, Boorjian SA, Thompson RH, Eisenberg MS, Carlson RE, Bergstralh EJ et al. Oncological outcomes following radical prostatectomy for patients with pT4 prostate cancer. International Braz J Urol. 2016;42(6):1091-1098. https://doi.org/10.1590/S1677-5538.IBJU.2016.0290
Kaushik, Dharam ; Boorjian, Stephen A. ; Thompson, R. Houston ; Eisenberg, Manuel S. ; Carlson, Rachel E. ; Bergstralh, Eric J. ; Frank, Igor ; Gettman, Matthew T. ; Tollefson, Matthew K. ; Karnes, Robert Jeffrey. / Oncological outcomes following radical prostatectomy for patients with pT4 prostate cancer. In: International Braz J Urol. 2016 ; Vol. 42, No. 6. pp. 1091-1098.
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abstract = "Objectives: Radical prostatectomy (RP) for locally advanced prostate cancer may reduce the risk of metastasis and cancer-specific death. Herein, we evaluated the outcomes for patients with pT4 disease treated with RP. Materials and methods: Among 19,800 men treated with RP at Mayo Clinic from 1987 to 2010, 87 were found to have pT4 tumors. Biochemical recurrence (BCR)-free survival, systemic progression (SP) free survival and overall survival (OS) were estimated using the Kaplan-Meier method and compared with the log-rank test. Cox proportional hazards regression models were used to assess the association of clinic-pathological features with outcome. Results: Median follow-up was 9.8 years (IQR 3.6, 13.4). Of the 87 patients, 50 (57.5{\%}) were diagnosed with BCR, 30 (34.5{\%}) developed SP, and 38 (43.7{\%}) died, with 11 (12.6{\%}) dying of prostate cancer. Adjuvant androgen deprivation therapy was administered to 77 men, while 32 received adjuvant external beam radiation therapy. Tenyear BCR-free survival, SP-free survival, and OS was 37{\%}, 64{\%}, and 70{\%} respectively. On multivariate analysis, the presence of positive lymph nodes was marginally significantly associated with patients' risk of BCR (HR: 1.94; p=0.05), while both positive lymph nodes (HR 2.96; p=0.02) and high pathologic Gleason score (HR 1.95; p=0.03) were associated with SP. Conclusions: Patients with pT4 disease may experience long-term survival following RP, and as such, when technically feasible, surgical resection should be considered in the multimodal treatment approach to these men.",
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AU - Kaushik, Dharam

AU - Boorjian, Stephen A.

AU - Thompson, R. Houston

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AU - Carlson, Rachel E.

AU - Bergstralh, Eric J.

AU - Frank, Igor

AU - Gettman, Matthew T.

AU - Tollefson, Matthew K.

AU - Karnes, Robert Jeffrey

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N2 - Objectives: Radical prostatectomy (RP) for locally advanced prostate cancer may reduce the risk of metastasis and cancer-specific death. Herein, we evaluated the outcomes for patients with pT4 disease treated with RP. Materials and methods: Among 19,800 men treated with RP at Mayo Clinic from 1987 to 2010, 87 were found to have pT4 tumors. Biochemical recurrence (BCR)-free survival, systemic progression (SP) free survival and overall survival (OS) were estimated using the Kaplan-Meier method and compared with the log-rank test. Cox proportional hazards regression models were used to assess the association of clinic-pathological features with outcome. Results: Median follow-up was 9.8 years (IQR 3.6, 13.4). Of the 87 patients, 50 (57.5%) were diagnosed with BCR, 30 (34.5%) developed SP, and 38 (43.7%) died, with 11 (12.6%) dying of prostate cancer. Adjuvant androgen deprivation therapy was administered to 77 men, while 32 received adjuvant external beam radiation therapy. Tenyear BCR-free survival, SP-free survival, and OS was 37%, 64%, and 70% respectively. On multivariate analysis, the presence of positive lymph nodes was marginally significantly associated with patients' risk of BCR (HR: 1.94; p=0.05), while both positive lymph nodes (HR 2.96; p=0.02) and high pathologic Gleason score (HR 1.95; p=0.03) were associated with SP. Conclusions: Patients with pT4 disease may experience long-term survival following RP, and as such, when technically feasible, surgical resection should be considered in the multimodal treatment approach to these men.

AB - Objectives: Radical prostatectomy (RP) for locally advanced prostate cancer may reduce the risk of metastasis and cancer-specific death. Herein, we evaluated the outcomes for patients with pT4 disease treated with RP. Materials and methods: Among 19,800 men treated with RP at Mayo Clinic from 1987 to 2010, 87 were found to have pT4 tumors. Biochemical recurrence (BCR)-free survival, systemic progression (SP) free survival and overall survival (OS) were estimated using the Kaplan-Meier method and compared with the log-rank test. Cox proportional hazards regression models were used to assess the association of clinic-pathological features with outcome. Results: Median follow-up was 9.8 years (IQR 3.6, 13.4). Of the 87 patients, 50 (57.5%) were diagnosed with BCR, 30 (34.5%) developed SP, and 38 (43.7%) died, with 11 (12.6%) dying of prostate cancer. Adjuvant androgen deprivation therapy was administered to 77 men, while 32 received adjuvant external beam radiation therapy. Tenyear BCR-free survival, SP-free survival, and OS was 37%, 64%, and 70% respectively. On multivariate analysis, the presence of positive lymph nodes was marginally significantly associated with patients' risk of BCR (HR: 1.94; p=0.05), while both positive lymph nodes (HR 2.96; p=0.02) and high pathologic Gleason score (HR 1.95; p=0.03) were associated with SP. Conclusions: Patients with pT4 disease may experience long-term survival following RP, and as such, when technically feasible, surgical resection should be considered in the multimodal treatment approach to these men.

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