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CANCER CONTROL AND QUALITY-OF-LIFE FOLLOWING ANATOMICAL RADICAL RETROPUBIC PROSTATECTOMY - RESULTS AT 10 YEARS
Author(s): WALSH PC, PARTIN AW, EPSTEIN JI
Source: JOURNAL OF UROLOGY    Volume: 152    Issue: 5    Pages: 1831-1836    Part: Part 2    Published: NOV 1994  
Times Cited: 406     References: 29     
Abstract: The experience after 10 years with anatomical radical retropubic prostatectomy at The Johns Hopkins Hospital is reviewed. Between April 1982 and March 1991, 955 men with clinically localized prostate cancer (clinical stages T1 to T2) underwent staging pelvic lymphadenectomy and anatomical radical retropubic prostatectomy. Using actuarial analysis, at 10 years the likelihood of an undetectable prostate specific antigen (PSA) level was 70%, isolated elevation of PSA 23%, distant metastases 7% and local recurrence 4%. The actuarial likelihood of an elevated serum PSA increased with increasing pathological stage: the 10-year likelihood of freedom from PSA relapse was 85% for men with organ confined disease, 82% with focal capsular penetration, 54% with established capsular penetration and Gleason score 2 to 6 disease, 42% with established capsular penetration and Gleason score 7 to 10 disease, and 43% with seminal vesicle involvement. These data indicate that radical prostatectomy cures the majority of men with organ confined disease or with well to moderately well differentiated tumors that have penetrated the prostatic capsule to the extent where it is possible to obtain a clear surgical margin. Radical prostatectomy should be reserved for patients who can be cured and who will live long enough to benefit from it. These are also the patients who have the best quality of life postoperatively.
Document Type: Proceedings Paper
Language: English
Reprint Address: WALSH, PC (reprint author), JOHNS HOPKINS MED INST, JAMES BUCHANAN BRADY UROL INST, DEPT UROL, BALTIMORE, MD 21205 USA
Addresses:
1. JOHNS HOPKINS MED INST, JAMES BUCHANAN BRADY UROL INST, DEPT PATHOL, BALTIMORE, MD 21205 USA
Publisher: WILLIAMS & WILKINS, 351 WEST CAMDEN ST, BALTIMORE, MD 21201-2436
Subject Category: Urology & Nephrology
IDS Number: PL686
ISSN: 0022-5347
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