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Long-term, European outcomes to RP in the PSA era

Posted Jan 06 2010 12:00am

Isbarn et al. (a German group working in Hamburg) have reported the first long-term survival data in response to radical prostatectomy (RP) from a European country since the beginning of the PSA era.

Their data is from a single-institution series of 436 patients followed for a median of about 10 years after treatment, which limits the degree to which these data can be broadly applied. However, in this series of patients, what they have shown is as follows:

  • All patients were treated with radical prostatectomy (RP) between 1992 and 1997 at the authors’ institution.
  • None of the patients received adjuvant or salvage therapy in unless they had a well-defined biochemical recurrence (i.e., a rising PSA level post-surgery).
  • The biochemical recurrence-free survival rate was 60 percent at a median follow-up of 122 months.
  • The prostate cancer-specific survival rate was  94 percent at a median follow-up of 128 months.
  • The  overall survival rate was 86 percent at a median follow-up 0f 132 months.
  • Preoperative PSA level, the Gleason score at the time of surgery (the pathological Gleason score), the pathologic T stage, lymph node status, and surgical margin status were all independent predictors of biochemical recurrence.

Based on these data, the authors conclude that, at their institution, “RP provides excellent long-term survival rates in patients with clinically localized prostate cancer,” with a prostate cancer-specific mortality rate of only 6 percent at 10 years.

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