Results of radical prostatectomy in men with locally advanced prostate cancer: multi-institutional pooled analysis.


Journal Article

OBJECTIVE: We investigated the disease-specific and metastasis-free survival rates in men with locally advanced (clinical stage T3) prostate cancer who were treated surgically. METHODS: A retrospective, multi-institutional pooled analysis of the results of surgical treatment in 345 men with clinical stage T3 disease was performed. Survival curves were generated using the Kaplan-Meier method. RESULTS: Among 298 evaluable patients, pelvic lymphadenectomy alone was performed in 56 men (19%), while 242 men (81%) underwent node dissection and radical prostatectomy. In total, 122 of 298 patients (41%) had nodal metastases and/or seminal vesicle tumor spread. Pathologically organ-confined disease was noted in 27 men (9%). The actuarial 10-year disease-specific and metastasis-free survival rates for all patients managed surgically were 57 and 32%, respectively. For patients with well, moderately and poorly differentiated tumors, cancer-specific survival rates at 10 years were 73, 67 and 29%, respectively. CONCLUSIONS: A large number of men with clinical stage T3 prostate cancer have advanced disease and are unlikely to achieve improved long-term survival with surgery alone. Although there may be a role for radical prostatectomy in selected patients with low to intermediate grade tumors, such treatment appears unlikely to result in long-term survival in men with high grade disease. A prospective study is necessary to determine the optimal treatment approach in men with locally advanced prostate cancer.

Full Text

Duke Authors

Cited Authors

  • Gerber, GS; Thisted, RA; Chodak, GW; Schroder, FH; Frohmuller, HG; Scardino, PT; Paulson, DF; Middleton, AW; Rukstalis, DB; Smith, JA; Ohori, M; Theiss, M; Schellhammer, PF

Published Date

  • 1997

Published In

Volume / Issue

  • 32 / 4

Start / End Page

  • 385 - 390

PubMed ID

  • 9412793

Pubmed Central ID

  • 9412793

International Standard Serial Number (ISSN)

  • 0302-2838


  • eng

Conference Location

  • Switzerland