Pathological findings and prostate‐specific antigen outcomes after laparoscopic radical prostatectomy for high‐risk prostate cancer
Study Type – Therapy (case series) Level of Evidence 4 OBJECTIVE To review the biochemical recurrence‐free survival (RFS) rates of laparoscopic radical prostatectomy (LRP) in patients with a high risk of disease progression as defined by preoperative criteria of D’Amico et al. PATIENTS AND METHODS B...
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| Veröffentlicht in: | BJU international 2010-07, Vol.106 (1), p.86-90 |
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| creator | Ploussard, Guillaume Salomon, Laurent Allory, Yves Terry, Stéphane Vordos, Dimitri Hoznek, Andreas Abbou, Claude‐Clément Vacherot, Francis De La Taille, Alexandre |
| description | Study Type – Therapy (case series)
Level of Evidence 4
OBJECTIVE
To review the biochemical recurrence‐free survival (RFS) rates of laparoscopic radical prostatectomy (LRP) in patients with a high risk of disease progression as defined by preoperative criteria of D’Amico et al.
PATIENTS AND METHODS
Between October 2000 and May 2008, 110 patients had extraperitoneal LRP and bilateral pelvic lymph node sampling for high‐risk prostate cancer in our department. High‐risk prostate cancer was defined as a prostate‐specific antigen (PSA) level of >20 ng/mL, and/or a biopsy Gleason score ≥8, and/or a clinical stage of T2c–T4 stage. The median follow‐up was 37.6 months. Risk factors for time to biochemical recurrence were tested using log‐rank survivorship analysis and Cox proportional hazards regression.
RESULTS
Prostate cancer was organ‐confined in 36% of patients; the Overall RFS was 79.4% and 69.8% at 1 and 3 years, respectively. The 3‐year RFS rates for organ‐confined cancer vs extracapsular extension were 100% and 54.3%, respectively (P |
| doi_str_mv | 10.1111/j.1464-410X.2009.09080.x |
| format | Article |
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Level of Evidence 4
OBJECTIVE
To review the biochemical recurrence‐free survival (RFS) rates of laparoscopic radical prostatectomy (LRP) in patients with a high risk of disease progression as defined by preoperative criteria of D’Amico et al.
PATIENTS AND METHODS
Between October 2000 and May 2008, 110 patients had extraperitoneal LRP and bilateral pelvic lymph node sampling for high‐risk prostate cancer in our department. High‐risk prostate cancer was defined as a prostate‐specific antigen (PSA) level of >20 ng/mL, and/or a biopsy Gleason score ≥8, and/or a clinical stage of T2c–T4 stage. The median follow‐up was 37.6 months. Risk factors for time to biochemical recurrence were tested using log‐rank survivorship analysis and Cox proportional hazards regression.
RESULTS
Prostate cancer was organ‐confined in 36% of patients; the Overall RFS was 79.4% and 69.8% at 1 and 3 years, respectively. The 3‐year RFS rates for organ‐confined cancer vs extracapsular extension were 100% and 54.3%, respectively (P < 0.001). The 3‐year RFS rates for tumour‐free seminal vesicle vs seminal vesicle invasion were 81.8% and 33.6%, respectively (P < 0.001). The 3‐year RFS rates for negative surgical margins vs positive were 85.2% and 47.3%, respectively (P = 0.001). Compared with men with any single pathological risk factor or any two risk factors, men with all three risk factors had a significantly shorter time to PSA failure after LRP (log‐rank test, P < 0.001).
CONCLUSION
Among patients at increased risk of disease progression as defined by preoperative criteria, a third of men with organ‐confined disease have a favourable prognosis. Men at high risk for early PSA failure could be better identified by pathological assessment of RP specimens, and selected for phase III randomized trials investigating adjuvant systemic treatment.</description><identifier>ISSN: 1464-4096</identifier><identifier>EISSN: 1464-410X</identifier><identifier>DOI: 10.1111/j.1464-410X.2009.09080.x</identifier><identifier>PMID: 19930177</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Adult ; Aged ; biochemical recurrence ; Biochemistry, Molecular Biology ; Biological and medical sciences ; Epidemiologic Methods ; Gynecology. Andrology. Obstetrics ; high risk ; Humans ; Life Sciences ; Male ; Male genital diseases ; Medical sciences ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Recurrence, Local - metabolism ; Neoplasm Recurrence, Local - pathology ; Nephrology. Urinary tract diseases ; Prostate ; Prostate - metabolism ; Prostate - pathology ; Prostate - surgery ; prostate cancer ; Prostate-Specific Antigen ; Prostate-Specific Antigen - metabolism ; Prostatectomy ; Prostatectomy - methods ; Prostatic Neoplasms ; Prostatic Neoplasms - metabolism ; Prostatic Neoplasms - pathology ; Prostatic Neoplasms - surgery ; radical prostatectomy ; Treatment Outcome ; Tumors ; Tumors of the urinary system ; Urinary tract. Prostate gland</subject><ispartof>BJU international, 2010-07, Vol.106 (1), p.86-90</ispartof><rights>2009 THE AUTHORS. JOURNAL COMPILATION © 2009 BJU INTERNATIONAL</rights><rights>2015 INIST-CNRS</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4850-3ff67c97084ab783fcc0872f6deacb84c572f29709051d036a83e417b20226a13</citedby><cites>FETCH-LOGICAL-c4850-3ff67c97084ab783fcc0872f6deacb84c572f29709051d036a83e417b20226a13</cites><orcidid>0000-0002-6004-2152 ; 0000-0002-5526-077X ; 0000-0003-3089-7886</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1464-410X.2009.09080.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1464-410X.2009.09080.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22891904$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19930177$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://inserm.hal.science/inserm-00502462$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Ploussard, Guillaume</creatorcontrib><creatorcontrib>Salomon, Laurent</creatorcontrib><creatorcontrib>Allory, Yves</creatorcontrib><creatorcontrib>Terry, Stéphane</creatorcontrib><creatorcontrib>Vordos, Dimitri</creatorcontrib><creatorcontrib>Hoznek, Andreas</creatorcontrib><creatorcontrib>Abbou, Claude‐Clément</creatorcontrib><creatorcontrib>Vacherot, Francis</creatorcontrib><creatorcontrib>De La Taille, Alexandre</creatorcontrib><title>Pathological findings and prostate‐specific antigen outcomes after laparoscopic radical prostatectomy for high‐risk prostate cancer</title><title>BJU international</title><addtitle>BJU Int</addtitle><description>Study Type – Therapy (case series)
Level of Evidence 4
OBJECTIVE
To review the biochemical recurrence‐free survival (RFS) rates of laparoscopic radical prostatectomy (LRP) in patients with a high risk of disease progression as defined by preoperative criteria of D’Amico et al.
PATIENTS AND METHODS
Between October 2000 and May 2008, 110 patients had extraperitoneal LRP and bilateral pelvic lymph node sampling for high‐risk prostate cancer in our department. High‐risk prostate cancer was defined as a prostate‐specific antigen (PSA) level of >20 ng/mL, and/or a biopsy Gleason score ≥8, and/or a clinical stage of T2c–T4 stage. The median follow‐up was 37.6 months. Risk factors for time to biochemical recurrence were tested using log‐rank survivorship analysis and Cox proportional hazards regression.
RESULTS
Prostate cancer was organ‐confined in 36% of patients; the Overall RFS was 79.4% and 69.8% at 1 and 3 years, respectively. The 3‐year RFS rates for organ‐confined cancer vs extracapsular extension were 100% and 54.3%, respectively (P < 0.001). The 3‐year RFS rates for tumour‐free seminal vesicle vs seminal vesicle invasion were 81.8% and 33.6%, respectively (P < 0.001). The 3‐year RFS rates for negative surgical margins vs positive were 85.2% and 47.3%, respectively (P = 0.001). Compared with men with any single pathological risk factor or any two risk factors, men with all three risk factors had a significantly shorter time to PSA failure after LRP (log‐rank test, P < 0.001).
CONCLUSION
Among patients at increased risk of disease progression as defined by preoperative criteria, a third of men with organ‐confined disease have a favourable prognosis. Men at high risk for early PSA failure could be better identified by pathological assessment of RP specimens, and selected for phase III randomized trials investigating adjuvant systemic treatment.</description><subject>Adult</subject><subject>Aged</subject><subject>biochemical recurrence</subject><subject>Biochemistry, Molecular Biology</subject><subject>Biological and medical sciences</subject><subject>Epidemiologic Methods</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>high risk</subject><subject>Humans</subject><subject>Life Sciences</subject><subject>Male</subject><subject>Male genital diseases</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local</subject><subject>Neoplasm Recurrence, Local - metabolism</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Prostate</subject><subject>Prostate - metabolism</subject><subject>Prostate - pathology</subject><subject>Prostate - surgery</subject><subject>prostate cancer</subject><subject>Prostate-Specific Antigen</subject><subject>Prostate-Specific Antigen - metabolism</subject><subject>Prostatectomy</subject><subject>Prostatectomy - methods</subject><subject>Prostatic Neoplasms</subject><subject>Prostatic Neoplasms - metabolism</subject><subject>Prostatic Neoplasms - pathology</subject><subject>Prostatic Neoplasms - surgery</subject><subject>radical prostatectomy</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><subject>Tumors of the urinary system</subject><subject>Urinary tract. Prostate gland</subject><issn>1464-4096</issn><issn>1464-410X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkc9uEzEQxi0EoiXwCmgviAtZxn92bR84lAooKBI9tBI3y_HaicPuerE3bXPjxpVn5EnwNmm44ovtmd98Hs-HUIGhxHm93ZSY1WzOMHwrCYAsQYKA8u4ROj0mHj-cQdYn6FlKG4AcqKun6ARLSQFzfop-XepxHdqw8ka3hfN94_tVKnTfFEMMadSj_fPzdxqs8c6bHB_9yvZF2I4mdDaDbrSxaPWgM23CkJmom3uxh3ozhm5XuBCLtV-ts1r06fsxWxjdGxufoydOt8m-OOwzdP3xw9X5xXzx9dPn87PF3DBRwZw6V3MjOQiml1xQZwwITlzdWG2WgpkqX0jOS6hwA7TWglqG-ZIAIbXGdIbe7HXXulVD9J2OOxW0VxdnC-X7ZGOnACogrCY3E_56j-d2f2xtGlXnk7Ftq3sbtklxSmlFeR7nDIk9afLHUrTuqI5BTaapjZr8UJM3ajJN3Zum7nLpy8Mj22Vnm3-FB5cy8OoA6JQn62IemU9HjhAhsQSWuXd77ta3dvffDaj3X66nE_0LJ523PQ</recordid><startdate>201007</startdate><enddate>201007</enddate><creator>Ploussard, Guillaume</creator><creator>Salomon, Laurent</creator><creator>Allory, Yves</creator><creator>Terry, Stéphane</creator><creator>Vordos, Dimitri</creator><creator>Hoznek, Andreas</creator><creator>Abbou, Claude‐Clément</creator><creator>Vacherot, Francis</creator><creator>De La Taille, Alexandre</creator><general>Blackwell Publishing Ltd</general><general>Wiley-Blackwell</general><general>Wiley</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>1XC</scope><scope>VOOES</scope><orcidid>https://orcid.org/0000-0002-6004-2152</orcidid><orcidid>https://orcid.org/0000-0002-5526-077X</orcidid><orcidid>https://orcid.org/0000-0003-3089-7886</orcidid></search><sort><creationdate>201007</creationdate><title>Pathological findings and prostate‐specific antigen outcomes after laparoscopic radical prostatectomy for high‐risk prostate cancer</title><author>Ploussard, Guillaume ; Salomon, Laurent ; Allory, Yves ; Terry, Stéphane ; Vordos, Dimitri ; Hoznek, Andreas ; Abbou, Claude‐Clément ; Vacherot, Francis ; De La Taille, Alexandre</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4850-3ff67c97084ab783fcc0872f6deacb84c572f29709051d036a83e417b20226a13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Aged</topic><topic>biochemical recurrence</topic><topic>Biochemistry, Molecular Biology</topic><topic>Biological and medical sciences</topic><topic>Epidemiologic Methods</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>high risk</topic><topic>Humans</topic><topic>Life Sciences</topic><topic>Male</topic><topic>Male genital diseases</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local</topic><topic>Neoplasm Recurrence, Local - metabolism</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Prostate</topic><topic>Prostate - metabolism</topic><topic>Prostate - pathology</topic><topic>Prostate - surgery</topic><topic>prostate cancer</topic><topic>Prostate-Specific Antigen</topic><topic>Prostate-Specific Antigen - metabolism</topic><topic>Prostatectomy</topic><topic>Prostatectomy - methods</topic><topic>Prostatic Neoplasms</topic><topic>Prostatic Neoplasms - metabolism</topic><topic>Prostatic Neoplasms - pathology</topic><topic>Prostatic Neoplasms - surgery</topic><topic>radical prostatectomy</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><topic>Tumors of the urinary system</topic><topic>Urinary tract. Prostate gland</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ploussard, Guillaume</creatorcontrib><creatorcontrib>Salomon, Laurent</creatorcontrib><creatorcontrib>Allory, Yves</creatorcontrib><creatorcontrib>Terry, Stéphane</creatorcontrib><creatorcontrib>Vordos, Dimitri</creatorcontrib><creatorcontrib>Hoznek, Andreas</creatorcontrib><creatorcontrib>Abbou, Claude‐Clément</creatorcontrib><creatorcontrib>Vacherot, Francis</creatorcontrib><creatorcontrib>De La Taille, Alexandre</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>Hyper Article en Ligne (HAL) (Open Access)</collection><jtitle>BJU international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ploussard, Guillaume</au><au>Salomon, Laurent</au><au>Allory, Yves</au><au>Terry, Stéphane</au><au>Vordos, Dimitri</au><au>Hoznek, Andreas</au><au>Abbou, Claude‐Clément</au><au>Vacherot, Francis</au><au>De La Taille, Alexandre</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pathological findings and prostate‐specific antigen outcomes after laparoscopic radical prostatectomy for high‐risk prostate cancer</atitle><jtitle>BJU international</jtitle><addtitle>BJU Int</addtitle><date>2010-07</date><risdate>2010</risdate><volume>106</volume><issue>1</issue><spage>86</spage><epage>90</epage><pages>86-90</pages><issn>1464-4096</issn><eissn>1464-410X</eissn><abstract>Study Type – Therapy (case series)
Level of Evidence 4
OBJECTIVE
To review the biochemical recurrence‐free survival (RFS) rates of laparoscopic radical prostatectomy (LRP) in patients with a high risk of disease progression as defined by preoperative criteria of D’Amico et al.
PATIENTS AND METHODS
Between October 2000 and May 2008, 110 patients had extraperitoneal LRP and bilateral pelvic lymph node sampling for high‐risk prostate cancer in our department. High‐risk prostate cancer was defined as a prostate‐specific antigen (PSA) level of >20 ng/mL, and/or a biopsy Gleason score ≥8, and/or a clinical stage of T2c–T4 stage. The median follow‐up was 37.6 months. Risk factors for time to biochemical recurrence were tested using log‐rank survivorship analysis and Cox proportional hazards regression.
RESULTS
Prostate cancer was organ‐confined in 36% of patients; the Overall RFS was 79.4% and 69.8% at 1 and 3 years, respectively. The 3‐year RFS rates for organ‐confined cancer vs extracapsular extension were 100% and 54.3%, respectively (P < 0.001). The 3‐year RFS rates for tumour‐free seminal vesicle vs seminal vesicle invasion were 81.8% and 33.6%, respectively (P < 0.001). The 3‐year RFS rates for negative surgical margins vs positive were 85.2% and 47.3%, respectively (P = 0.001). Compared with men with any single pathological risk factor or any two risk factors, men with all three risk factors had a significantly shorter time to PSA failure after LRP (log‐rank test, P < 0.001).
CONCLUSION
Among patients at increased risk of disease progression as defined by preoperative criteria, a third of men with organ‐confined disease have a favourable prognosis. Men at high risk for early PSA failure could be better identified by pathological assessment of RP specimens, and selected for phase III randomized trials investigating adjuvant systemic treatment.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>19930177</pmid><doi>10.1111/j.1464-410X.2009.09080.x</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0002-6004-2152</orcidid><orcidid>https://orcid.org/0000-0002-5526-077X</orcidid><orcidid>https://orcid.org/0000-0003-3089-7886</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
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| ispartof | BJU international, 2010-07, Vol.106 (1), p.86-90 |
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| recordid | cdi_hal_primary_oai_HAL_inserm_00502462v1 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adult Aged biochemical recurrence Biochemistry, Molecular Biology Biological and medical sciences Epidemiologic Methods Gynecology. Andrology. Obstetrics high risk Humans Life Sciences Male Male genital diseases Medical sciences Middle Aged Neoplasm Recurrence, Local Neoplasm Recurrence, Local - metabolism Neoplasm Recurrence, Local - pathology Nephrology. Urinary tract diseases Prostate Prostate - metabolism Prostate - pathology Prostate - surgery prostate cancer Prostate-Specific Antigen Prostate-Specific Antigen - metabolism Prostatectomy Prostatectomy - methods Prostatic Neoplasms Prostatic Neoplasms - metabolism Prostatic Neoplasms - pathology Prostatic Neoplasms - surgery radical prostatectomy Treatment Outcome Tumors Tumors of the urinary system Urinary tract. Prostate gland |
| title | Pathological findings and prostate‐specific antigen outcomes after laparoscopic radical prostatectomy for high‐risk prostate cancer |
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