Clinical outcomes of radical prostatectomy in patients with prostate cancer

We investigated the clinical outcomes of radical prostatectomy in patients with prostate cancer. This study included 101 men with prostate cancer who underwent radical prostatectomy between 1998 and 2007. Cancer-specific survival, predictors of prostate-specific antigen (PSA) failure, and incidence of clinically insignificant cancer were retrospectively analyzed. PSA failure was defined as a PSA level greater than 0.2 ng/ml. Clinically T1 cancers smaller than 0.5 ml with a Gleason score of 6 or less were defined as clinically insignificant cancer. Median follow-up was 60 months (range, 1-133 months). Twenty-five (25%) of the 101 patients underwent adjuvant therapy such as radiotherapy or androgen deprivation therapy, however, only one (1%) patient died of prostate cancer. The 5-year cancer-specific survival was 100%. PSA failure was confirmed in 26 (34%) of the 76 patients who did not undergo any adjuvant therapy. In univariate analysis, PSA 10< ng/ml (P=0.0013), pathological stage T3 (P=0.013), and positive surgical margin (P=0.0016) were predictors of PSA failure. Clinically insignificant cancers were identified in 4 (4%) patients. Since two of them were defined as a high-risk group at preoperative assessment, it was still difficult to predict these cancers before surgery. The incidence of clinically insignificant cancer was relatively low, and even in high-risk prostate cancer patients, the clinical outcomes of radical prostatectomy were excellent with adequate adjuvant therapy, and accordingly most prostate cancer patients should undergo treatment. (author)