Rodríguez-Covarrubias F, Castillejos-Molina RA, Sotomayor de Zavaleta M, Gabilondo-Navarro F, Feria-Bernal G

Language: Spanish
References: 19
Page: 273-277
PDF size: 144.93 Kb.

ABSTRACT

Objective: To see the progression of patients surgically treated for prostate cancer (PCa) that is locally advanced and/or with lymph node invasion (N+).
Materials and methods: A retrospective study of patients from our institution who presented with locally advanced and/or lymph node invading PCa and who were treated with radical retropubic prostatectomy (RRP) was carried out. Biochemical recurrence-free survival (BRFS) was evaluated using the Kaplan-Meier method in accordance with preoperative prostate specific antigen (PSA) level. BRFS in the risk groups was evaluated using the D’Amico classification. Multivariate analysis was used to study factors associated with biochemical recurrence, which was defined as a postoperative PSA › 0.4 ng/ml.
Results: The study group included 62 patients with a mean age of 63.09±7.16 years and initial PSA of 20.9±18.4 ng/ml. Seventeen patients (27.4%) had a Gleason score ≥ 8, thirty-two patients (51.6%) were in stage pT3b and thirteen patients (21%) presented with N+. Mean follow-up time was 41.65±30.07 months. Biochemical recurrence presented in 32 cases (51.6%). BRFS at 5 years in patients with PSA ‹10 and ≥10 ng/ ml was 69% and 20%, respectively (P=0.002). BRFS in the same time frame in low, intermediate and high risk patients was 85%, 49% and 16%, respectively (P=0.04). In the multivariate analysis, risk groups were associated with the possibility of biochemical recurrence (P=0.02).
Conclusions: Patients presenting with locally advanced and/or lymph node invading PCa had poor prognosis after RRP. Adequate oncological control is possible in those patients with initial PSA ‹ 10 ng/ml, who fit lowrisk group criteria.

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