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Open Access 01-12-2014 | Research article

Long-term results of radical prostatectomy with immediate adjuvant androgen deprivation therapy for pT3N0 prostate cancer

Authors: Yuzuri Tsurumaki Sato, Hiroshi Fukuhara, Motofumi Suzuki, Tetsuya Fujimura, Tohru Nakagawa, Hiroaki Nishimatsu, Haruki Kume, Teppei Morikawa, Masashi Fukayama, Yukio Homma

Published in: BMC Urology | Issue 1/2014

Abstract

Background

Radical prostatectomy is used to treat patients with clinically localized prostate cancer, but there have been few reports of its use in locally advanced disease. We evaluated the long-term results of radical prostatectomy and immediate adjuvant androgen deprivation therapy in Japanese patients with pT3N0M0 prostate cancer.

Methods

We retrospectively reviewed 128 patients with pT3N0M0 prostate cancer who underwent radical prostatectomy at our institute from 2000 to 2006. All pT3N0 patients were treated with adjuvant androgen deprivation therapy shortly after radical prostatectomy. Immediate adjuvant androgen deprivation therapy was continued for at least 5 years. Twenty-three were excluded because of preoperative hormonal therapy, missing data, or others. Death from any cause, death from prostate cancer, clinical recurrence and hormone-refractory biochemical progression were analyzed by Kaplan-Meier graphs. Relative risks of progression were estimated using Cox proportional hazards models with 95% confidence intervals.

Results

The 10-year hormone-refractory biochemical progression-free survival rate was 88.3% and the cancer-specific survival rate was 96.3% after a median follow-up period of 8.2 years (range 25.6-155.6 months). Higher clinical stage (p = 0.013), higher Gleason score at biopsy (p = 0.001), seminal vesicle invasion (p = 0.003) and microlymphatic invasion (p = 0.006) were predictive factors for hormone-refractory biochemical progression by univariate analyses. Multivariate analyses identified Gleason score at biopsy (p = 0.027) and seminal vesicle invasion (p = 0.030) as independent prognostic factors for hormone-refractory biochemical progression. None of the patients with clinical T1 cancers (n = 20), negative surgical margin (n = 12), or negative perineural invasion (n = 11) experienced hormone-refractory biochemical progression.

Conclusions

Radical prostatectomy with immediate adjuvant androgen deprivation therapy may be a valid treatment option for patients with pT3N0M0 prostate cancer.

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The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2490/14/13/prepub

Title: Long-term results of radical prostatectomy with immediate adjuvant androgen deprivation therapy for pT3N0 prostate cancer
Authors: Yuzuri Tsurumaki Sato
Hiroshi Fukuhara
Motofumi Suzuki
Tetsuya Fujimura
Tohru Nakagawa
Hiroaki Nishimatsu
Haruki Kume
Teppei Morikawa
Masashi Fukayama
Yukio Homma
Publication date: 01-12-2014
Publisher: BioMed Central
Published in: BMC Urology / Issue 1/2014
Electronic ISSN: 1471-2490
DOI: https://doi.org/10.1186/1471-2490-14-13

At a glance: The STEP trials

Springer Medicine

Long-term results of radical prostatectomy with immediate adjuvant androgen deprivation therapy for pT3N0 prostate cancer

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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