Radical prostatectomy as radical cure of prostate cancer in a high-risk group: A single-institution experience

This study aimed to evaluate the possibility of performing radical prostatectomy (RP) alone to achieve radical cure of prostate cancer in a high-risk group. Between August 1998 and December 2008, 436 Japanese patients underwent antegrade RP following the exclusion of 139 patients. According to the D'Amico criteria, the low-, intermediate- and high-risk groups comprised 63, 122 and 112 patients, respectively. Twenty-five patients who were classified into the high-risk group based only on T2c stage, were evaluated as a separate intermediate/high-risk group. Results of the multivariate analysis revealed that of the preoperative characteristics only a biopsy Gleason score was a significant predictor in patients with and without PSA failure (P=0.017). After a median follow-up period of 60 months, the PSA failure-free rates in the low-, intermediate-, high- and intermediate/high-risk groups were 96.5, 92.2, 76.8 and 95.0%, respectively. No statistically significant difference was detected in the high- and intermediate/high-risk groups (P=0.064). Thus, patients classified into the high-risk group based on cT2 stage only, are considered to be potentially eligible for radical treatment by surgery alone, and should not be evaluated as high-risk patients.