Contemporary update of cancer control after radical prostatectomy in the UK

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Title: Contemporary update of cancer control after radical prostatectomy in the UK
Authors: Winkler, MH
Khan, FA
Shabir, M
Okeke, A
Sugiono, M
McInerney, P
Boustead, GB
Persad, R
Kaisary, AV
Gillatt, DA
Item Type: Journal Article
Abstract: Despite a significant increase of the number of radical prostatectomies (RPs) to treat organ-confined prostate cancer, there is very limited documentation of its oncological outcome in the UK. Pathological stage distribution and changes of outcome have not been audited on a consistent basis. We present the results of a multicentre review of postoperative predictive variables and prostatic-specific antigen (PSA) recurrence after RP for clinically organ-confined disease. In all, 854 patient's notes were audited for staging parameters and follow-up data obtained. Patients with neoadjuvant and adjuvant treatment as well as patients with incomplete data and follow-up were excluded. Median follow-up was 52 months for the remaining 705 patients. The median PSA was 10 ng ml−1. A large migration towards lower PSA and stage was seen. This translated into improved PSA survival rates. Overall Kaplan–Meier PSA recurrence-free survival probability at 1, 3, 5 and 8 years was 0.83, 0.69, 0.60 and 0.48, respectively. The 5-year PSA recurrence-free survival probability for PSA ranges <4, 4.1–10, 10.1–20 and >20 ng ml−1 was 0.82, 0.73, 0.59 and 0.20, respectively (log rank, P<0.0001). PSA recurrence-free survival probabilities for pathological Gleason grade 2–4, 5 and 6, 7 and 8–10 at 5 years were 0.84, 0.66, 0.55 and 0.21, respectively (log rank, P<0.0001). Similarly, 5-year PSA recurrence-free survival probabilities for pathological stages T2a, T2b, T3a, T3b and T4 were 0.82, 0.78, 0.48, 0.23 and 0.12, respectively (log rank, P=0.0012). Oncological outcome after RP has improved over time in the UK. PSA recurrence-free survival estimates are less optimistic compared to quoted survival figures in the literature. Survival figures based on pathological stage and Gleason grade may serve to counsel patients postoperatively and to stratify patients better for adjuvant treatment.
Issue Date: 29-Nov-2004
Date of Acceptance: 9-Sep-2004
URI: http://hdl.handle.net/10044/1/93308
DOI: 10.1038/sj.bjc.6602206
ISSN: 0007-0920
Publisher: Springer Nature [academic journals on nature.com]
Start Page: 1853
End Page: 1857
Journal / Book Title: British Journal of Cancer
Volume: 91
Issue: 11
Copyright Statement: © 2004 Cancer Research UK. This paper was modified 12 months after initial publication to switch to Creative Commons licence terms, as noted at publication.
Keywords: Science & Technology
Life Sciences & Biomedicine
Oncology
prostate neoplasm
adenocarcinoma
radical prostatectomy
prostate-specific antigen
RETROPUBIC PROSTATECTOMY
ANTIGEN
TRENDS
PSA
EPIDEMIOLOGY
RECURRENCE
CARCINOMA
Humans
Male
Middle Aged
Neoadjuvant Therapy
Neoplasm Recurrence, Local
Neoplasm Staging
Postoperative Care
Preoperative Care
Prostate-Specific Antigen
Prostatectomy
Prostatic Neoplasms
Survival Rate
United Kingdom
Humans
Prostatic Neoplasms
Neoplasm Recurrence, Local
Prostate-Specific Antigen
Neoplasm Staging
Neoadjuvant Therapy
Postoperative Care
Preoperative Care
Prostatectomy
Survival Rate
Middle Aged
Male
United Kingdom
Science & Technology
Life Sciences & Biomedicine
Oncology
prostate neoplasm
adenocarcinoma
radical prostatectomy
prostate-specific antigen
RETROPUBIC PROSTATECTOMY
ANTIGEN
TRENDS
PSA
EPIDEMIOLOGY
RECURRENCE
CARCINOMA
1112 Oncology and Carcinogenesis
1117 Public Health and Health Services
Oncology & Carcinogenesis
Publication Status: Published
Online Publication Date: 2004-11-02
Appears in Collections:Department of Surgery and Cancer



This item is licensed under a Creative Commons License Creative Commons