Winkler, MH and Khan, FA and Shabir, M and Okeke, A and Sugiono, M and McInerney, P and Boustead, GB and Persad, R and Kaisary, AV and Gillatt, DA (2004) Contemporary update of cancer control after radical prostatectomy in the UK. British Journal of Cancer , 91 (11) 1853 - 1857.
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Despite a significant increase of the number of radical prostatectomies (RPs) to treat organ-confined prostate cancer, there is very limited documentation of its oncological outcome in the UK. Pathological stage distribution and changes of outcome have not been audited on a consistent basis. We present the results of a multicentre review of postoperative predictive variables and prostatic-specific antigen (PSA) recurrence after RP for clinically organ-confined disease. In all, 854 patient's notes were audited for staging parameters and follow-up data obtained. Patients with neoadjuvant and adjuvant treatment as well as patients with incomplete data and follow-up were excluded. Median follow-up was 52 months for the remaining 705 patients. The median PSA was 10 ng ml(-1). A large migration towards lower PSA and stage was seen. This translated into improved PSA survival rates. Overall Kaplan-Meier PSA recurrence-free survival probability at 1, 3, 5 and 8 years was 0.83, 0.69, 0.60 and 0.48, respectively. The 5-year PSA recurrence-free survival probability for PSA ranges <4, 4.1 - 10, 10.1 - 20 and >20 ng ml(-1) was 0.82, 0.73, 0.59 and 0.20, respectively ( log rank, P<0.0001). PSA recurrence-free survival probabilities for pathological Gleason grade 2 - 4, 5 and 6, 7 and 8 - 10 at 5 years were 0.84, 0.66, 0.55 and 0.21, respectively ( log rank, P<0.0001). Similarly, 5-year PSA recurrence-free survival probabilities for pathological stages T2a, T2b, T3a, T3b and T4 were 0.82, 0.78, 0.48, 0.23 and 0.12, respectively ( log rank, P = 0.0012). Oncological outcome after RP has improved over time in the UK. PSA recurrence-free survival estimates are less optimistic compared to quoted survival figures in the literature. Survival figures based on pathological stage and Gleason grade may serve to counsel patients postoperatively and to stratify patients better for adjuvant treatment
|Title:||Contemporary update of cancer control after radical prostatectomy in the UK|
|Additional information:||JournalArticleNOV 29873SQBRIT J CANCER|
|Keywords:||diagnosis, Great Britain, Humans, Male, metabolism, Middle Aged, mortality, Neoadjuvant Therapy, Neoplasm Recurrence, Local, Neoplasm Staging, pathology, Postoperative Care, Preoperative Care, Prostate-Specific Antigen, Prostatectomy, Prostatic Neoplasms, surgery, Survival Rate, adenocarcinoma, ANTIGEN, CARCINOMA, DATABASE, epidemiology, ERA, prostate neoplasm, prostate-specific antigen, PSA, radical prostatectomy, Recurrence, RETROPUBIC PROSTATECTOMY, SURVIVAL, trends|
|UCL classification:||UCL > School of Life and Medical Sciences > Faculty of Medical Sciences > Surgery and Interventional Science (Division of)|
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