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Organo Oficial de la Sociedad Mexicana de Urología

2012, Number 4

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Rev Mex Urol 2012; 72 (4)

Preoperative risk factors for locally advanced prostate cancer and their biochemical recurrence implication in patients that underwent radical prostatectomy

Schroeder-Ugalde IM, Xochipitécatl-Muñoz DJ, Navarro-Vargas JC, Velázquez-Macías R

Language: Spanish
References: 30
Page: 171-177
PDF size: 427.34 Kb.


ABSTRACT

Background: Radical prostatectomy continues to be the criterion standard for localized prostate cancer treatment. The average positive margin rate is 28% and is related to preoperative factors such as clinical stage, Gleason score, and preoperative PSA. Patients with positive surgical margins have a greater probability of biochemical progression.
Material and methods: In this study we analyzed the preoperative risk factors associated with locally advanced disease in the surgical specimen, the therapeutic options, and their implications in relation to biochemical recurrence.
Results: Seventy-one case records of patients that underwent radical prostatectomy at the advanced specialty hospital, Hospital Central Sur de PEMEX, were reviewed. Sixty-seven patients were included, 29 (43.2%) of which had locally advanced disease. The patients were classified into risk groups and in the PSA and Gleason score groups there was no statistical significance with a p›0.05. There was statistical significance in the clinical stage group with a p ‹ 0.05. Of the 11 patients with locally advanced disease that were kept under surveillance, 8 (72.7%) did not present with biochemical recurrence, with a mean follow-up of 39 months. The incidence increase in locally advanced disease in relation to the risk groups according to PSA and Gleason score could not be corroborated.
Conclusions: The low recurrence incidence in the patients that were kept under surveillance was an interesting result. Further studies are needed to clarify doubts as to the precise moment adjuvant treatment should be initiated in an effort to increase patient survival.


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