Twelve-year outcomes of prostate cancer after radical prostatectomy for T3 and/or positive margins managed with surveillance or salvage radiation therapy, based on risk groups

摘要

BackgroundTo assess 12-year outcomes on radical prostatectomy?with T3/positive margins, while categorizing patients into risk groups.MethodsFrom 2004 to 2007, 862 radical prostatectomy patients had T3/positive margins. Management included surveillance (54.8%), salvage radiation therapy (SRT) (36.8%), and primary androgen deprivation therapy (ADT) (8.5%). Freedom from biochemical failure, metastasis-free-survival (MFS), prostate cancer–specific survival (PCSS) were estimated using Kaplan-Meier. Multivariable analysis?established prognostic factors that affected PCSS, which were used to form risk groups. Subanalysis was performed on SRT patients.ResultsMedian follow-up was 12.1?years. T3b, Gleason score (GS), and detectable postoperative PSA independently lowered PCSS. Very–low-risk (VLR) were GS 6. Low-risk (LR) were GS 3?+?4 with T3a or positive margins, but undetectable postoperative PSA <0.1. High-risk (HR) were T3b with GS 7-10, or any GS 7-10 with T3a/b and positive margins, but undetectable PSA. Ultra–high-risk (UHR) were detectable PSA with GS 7-10. Median time to first salvage treatment for VLR, LR, HR, and UHR were 11.1, 10.8, 5.3, and 0.6?years, p?