Radical Prostatectomy as a First-Line Treatment in Patients with Initial PSA ＞20 ng/mL

Initial PSA >20 ng/mL is generally considered an adverse prognostic feature in prostate cancer (PCa). Our goals were to estimate the impact of radical prostatectomy (RP) on biochemical recurrence- (BCR-) free and cancer-specific survival (CSS) rates of PCa patients with PSA >20 ng/mL, and to identify patients with favorable oncological outcome. Using 20 ng/mL as a cut-point value, 205 PCa patients, who underwent RP, were stratified into two groups. Multivariate analysis was used to determine the significant outcome predictors among patients with PSA >20 ng/mL. Men in this group had significantly lower 10-yr BCR-free and CSS rates than patients with PSA ≤20 ng/mL (20.7% versus 79.6% (P