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Radical prostatectomy for high-grade prostate cancer
Mark D Hurwitz1, Delray Schultz, Jerome P Richie
1Harvard Medical School, and Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts 02115, USA. mhurwitz@lroc.harvard.edu
Urology
|August 15, 2006
Summary
For men with high-grade Gleason 8 to 10 prostate cancer, prostate-specific antigen (PSA) levels and percent positive biopsy cores (%PBC) help identify those likely to benefit from radical prostatectomy.
Area of Science:
- Urology
- Oncology
- Medical Statistics
Background:
- High-grade prostate cancer (Gleason 8-10) may have extracapsular extension, diminishing the long-term benefit of radical prostatectomy.
- Identifying patients most likely to benefit from surgery is crucial for treatment planning.
Purpose of the Study:
- To evaluate the utility of prognostic factors in selecting men with Gleason 8-10 prostate cancer for radical prostatectomy.
- To determine if prostate-specific antigen (PSA) and percent positive biopsy cores (%PBC) predict surgical outcomes.
Main Methods:
- Retrospective analysis of 168 men with Gleason 8-10 prostate cancer undergoing radical prostatectomy.
- Patients were stratified by PSA value (<10 ng/mL) and %PBC (<50%).
- Kaplan-Meier analysis assessed 5-year freedom from biochemical failure.
Main Results:
- Patients with PSA <10 ng/mL and %PBC <50% had a 67% 5-year biochemical control rate.
- All other patients had a significantly lower 5-year control rate of 23% (P=0.0001).
Conclusions:
- PSA and %PBC are valuable predictors for selecting high-grade prostate cancer patients for radical prostatectomy.
- These factors can help optimize surgical candidacy and improve patient outcomes.