Mp40-18 Long-term Oncological Outcomes Following Radical Prostatectomy for Clinical T1a and T1b Prostate Cancer
Year: 2016
Type: article
Study design: Observational Study
Abstract: You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy I1 Apr 2016MP40-18 LONG-TERM ONCOLOGICAL OUTCOMES FOLLOWING RADICAL PROSTATECTOMY FOR CLINICAL T1A AND T1B PROSTATE CANCER Daniel Moreira, Boris Gershman, Stephen Boorjian, R. Houston Thompson, Igor Frank, Matthew Tollefson, Matthew Gettman, Rachel Carlson, and R. Jeffrey Karnes Daniel MoreiraDaniel Moreira More articles by this author , Boris GershmanBoris Gershman More articles by this author , Stephen BoorjianStephen Boorjian More articles by this author , R. Houston ThompsonR. Houston Thompson More articles by this author , Igor FrankIgor Frank More articles by this author , Matthew TollefsonMatthew Tollefson More articles by this author , Matthew GettmanMatthew Gettman More articles by this author , Rachel CarlsonRachel Carlson More articles by this author , and R. Jeffrey KarnesR. Jeffrey Karnes More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.164AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Prostate cancer (PCa) is incidentally found in 4–16% of patients surgically treated for benign prostatic hyperplasia. It is staged as clinical T1a or T1b based on the percentage of tumor in the specimen: <5 vs =5%, respectively. The classical decision algorithm is to follow T1a and treat T1b. However, this recommendation stems from limited studies evaluating biochemical recurrence in small historical cohorts. Thus, analyzed time to disease recurrence, metastasis and disease-specific mortality in patients with T1a and T1b PCa treated with radical prostatectomy (RP). METHODS Retrospective analysis of 252 men undergoing RP for localized T1a and T1b PCa at Mayo Clinic from 1987-2008. Comparisons of baseline patient and disease characteristics between T1a and T1b were done with chi-square and ranksum tests. Recurrence-free survival was estimated using the Kaplan-Meier method and compared with log-rank test. Disease recurrence was defined as a prostate-specific antigen (PSA) > 0.2 ng/mL and/or biopsy-proven local recurrence. Metastasis was determined by imaging. Cause of death was obtained from death certificates. RESULTS A total of 86 (34%) and 166 (66%) men had cT1a and cT1b PCa, respectively. Compared to cT1b, cT1a men had less positive surgical margins and lower pathological Gleason score (P < 0.05 for both). No significant differences in preoperative PSA level, pathological tumor volume, extracapsular extension, seminal vesicle invasion or lymph node involvement were noted between cT1a and cT1b tumors (all P > 0.05). A total of 12 (14%) T1a and 45 (27%) T1b men developed disease recurrence over a median follow-up of 14.8 years. No cT1a and 9 (5%) cT1b men developed metastasis. No cT1a and 6 (4%) cT1b died of PCa. Compared to patients with cT1b tumors, cT1a patients had longer recurrence-free and metastasis-free survival (both P < 0.05) and a trend toward better disease-specific survival (P = 0.078; Figure). CONCLUSIONS cT1a PCa is associated with low stage and low grade disease. Although both cT1a and cT1b have very favorable prognoses after RP, a small but not negligible percentage of cT1b men will develop systemic progression and experience cancer-specific mortality, compared to no progression or PCa deaths in the T1a group. Our findings support active treatment for selected T1b PCa cases. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e558 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Daniel Moreira More articles by this author Boris Gershman More articles by this author Stephen Boorjian More articles by this author R. Houston Thompson More articles by this author Igor Frank More articles by this author Matthew Tollefson More articles by this author Matthew Gettman More articles by this author Rachel Carlson More articles by this author R. Jeffrey Karnes More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Source: The Journal of Urology
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2329000969