Loeb S, Schaeffer EM, Trock BJ, Humphreys EB, Epstein JI, and Walsh PC.
“What are the Outcomes of Radical Prostatectomy for High-Risk Prostate Cancer?”
Urology 2009, Nov 19 epub.
Link: http://www.ncbi.nlm.nih.gov/pubmed/19931898
Historically most men with D’Amico high-risk prostate cancer (clinical stage ≥T2c, biopsy Gleason score 8-10, or prostate-specific antigen >20 ng/mL) were treated with combined radiation therapy and hormonal therapy. This study shows that surgical treatment for carefully selected high risk patients can result in long-term progression–free survival. At 10 years, biochemical recurrence-free survival was 68%, metastasis-free survival was 84%, and prostate cancer-specific survival was 92%. The 10-year rate of freedom from any hormonal therapy was 71%. Of the 3 high-risk criteria, a biopsy Gleason score of 8-10 (vs ≤7) was the strongest independent predictor of biochemical recurrence, metastases, and prostate cancer death.