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Long-term outcome following radical prostatectomy for Gleason 8–10 prostatic adenocarcinoma

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Abstract

Purpose

Compared to low-grade disease, high-grade prostate cancers exhibit a higher rate of disease progression. As a result, there has been a trend to treat high-risk disease with methods other than surgery. The purpose of this study is to evaluate the long-term survival following radical prostatectomy (RRP) for non-metastatic Gleason 8–10 prostate adenocarcinoma (CaP).

Methods

All patients 75 years or less with Gleason 8–10 CaP that underwent RRP were identified from the SEER 18 database. Patients with metastatic disease, those who underwent other modalities of treatment, or with more than one primary cancer, were excluded. Data were analyzed for demographics, stage at presentation, treatment modality, and overall survival and cancer-specific survival.

Results

A total of 30,379 men met inclusion criteria. Mean age was 62.5 years and 82.5 % of patients were white. A total of 52.8 % of patients had T2 disease, and 73.1 % had node-negative disease, 80.2 % of patients underwent pelvic lymph node dissection, and 12.9 % underwent adjuvant radiation therapy. Overall survival for the entire cohort was 92.8, 78.6, 59.5, 38.6, and 20.0 % for 5, 10, 15, 20, and 25 years, respectively. Cancer-specific survival was 96.4, 89.5, 82.0, 72.9, and 68.8 % for 5, 10, 15, 20, and 25 years, respectively.

Conclusions

Although historically underutilized in patients with poorly differentiated disease, radical prostatectomy provides excellent long-term survival and should be offered to healthy patients.

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Acknowledgments

All authors of this research paper have directly participated in the planning, execution, or analysis of this study. All authors of this paper have read and approved the final version submitted. There are no directly related manuscripts or abstracts, published or unpublished, by any author(s) of this paper. The contents of this manuscript have not been copyrighted or published previously; are not now under consideration for publication elsewhere; and will not be copyrighted, submitted, or published elsewhere, while acceptance by the Journal is under consideration.

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There is no actual or potential conflict of interest in relation to this article.

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Authors and Affiliations

  1. Division of Urology, University of Missouri-Columbia School of Medicine, 1 Hospital Drive, Columbia, MO, 65203, USA

    Naveen Pokala, Jerry J. Trulson & Majdee Islam

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  1. Naveen Pokala
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  2. Jerry J. Trulson
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  3. Majdee Islam
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Correspondence to Naveen Pokala.

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Pokala, N., Trulson, J.J. & Islam, M. Long-term outcome following radical prostatectomy for Gleason 8–10 prostatic adenocarcinoma. World J Urol 32, 1385–1392 (2014). https://doi.org/10.1007/s00345-014-1253-1

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  • DOI: https://doi.org/10.1007/s00345-014-1253-1

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