A. Volpe

B. Frea

C. Terrone

E. De Lorenzis

G. Marchioro

G. Maso

M. Vidali

M. Zacchero

R. Tarabuzzi

S. Crivellaro

S. Zaramella

English

Giansilvio Marchioro

Gloria Maso

Matteo Vidali

Alessandro Volpe

Roberto Tarabuzzi

Stefano Zaramella

Monica Zacchero

Elisa De Lorenzis

Simone Crivellaro

Bruno Frea

Carlo Terrone

AIR Universita degli studi di Milano

convincing cancer-related outcomes. Patients with PSA≥20 ng/ml should be considered for an aggressiveapproach, starting with radical surgery. Most patients needadjuvant HT or RT. This study confirms that RP should beconsidered as the first step in a multimodality approach forclinically locally advanced PCa.References1 Van Poppel H and Joniau S: An analysis of radicalprostatectomy in advanced stage and high-grade prostatecancer. Eur Urol 53: 253-259, 2008.2 Gontero P, Marchioro G, Frea B et al: Is radicalprostatectomy feasible in all cases of locally advancednon-bone metastatic prostate cancer? Results of a single-institution study. Eur Urol 51: 922-930, 2007.3 Hsu CY, Wildhagen MF, Van Poppel H and Bangma CH:Prognostic factors for and outcome of locally advancedprostate cancer after radical prostatectomy. BJU Int Nov12, 2009.108DO PATIENTS TREATED WITH RADICALPROSTATECTOMY FOR LOCALLY ADVANCEDPROSTATE CANCER AND PSA >50 ng/ml HAVE AWORSE PROGNOSIS THAN PATIENTS WITHPSA>20 ng/ml?Giansilvio Marchioro1, Gloria Maso1, Matteo Vidali2,Alessandro Volpe1, Roberto Tarabuzzi1, Stefano Zaramella1, Monica Zacchero1, Elisa DeLorenzis1, Simone Crivellaro3, Bruno Frea3 and Carlo Terrone11Department of Urology, Maggiore della Carità Hospital,University of Eastern Piedmont, Novara, Italy; 2Clinical Chemistry Unit, University of EasternPiedmont, Novara, Italy; 3Department of Urology, Santa Maria della MisericordiaHospital, University of Udine, Udine, ItalyAim: To report the outcomes of a single institutional studyon 98 pts with clinically locally advanced prostate cancer(PCa) and prostate-specific antigen (PSA) ≥20 ng/ml whounderwent radical prostatectomy (RP) and pelviclymphadenectomy (PNLD).Patients and Methods: We performed a retrospectivereview of PCa patients who had initial PSA values above20 ng/ml (Group A), treated with RP between 1999 and2005. Overall (OS), cancer specific (CSS), clinicalprogression free (CPFS), and biochemical recurrence freesurvival (BRFS) of these patients were compared withthose of other patients who had initial PSA values above50 ng/ml (Group B). Biochemical recurrence was definedas a double rise in PSA levels over 0.2 ng/ml after RP.Adjuvant or salvage radiotherapy (RT) or hormonaltherapy (HT) were indicated according to institutionalprotocols. OS, CSS, CPFS and BRFS were calculated forthe entire cohort and select subGroups using the Kaplan-Meier method with log-rank test and Cox multivariateanalysis.Results: The mean age was 66 (range IQR 61.8-71)years, with no significant differences between Group A andB. Mean PSA was 30.4 (range IQR 24.4-45) ng/ml. Nodifferences between the two groups were observed forpathological stage, positive surgical margins and lymphnode involvement. Mean pathological Gleason score wassignificantly higher for Group B (p=0.005). Mean follow-up was 65.3 (range IQR 46.0–96.5) months. Table Idescribes OS, CSS and BRFS at 5 and 10 years for GroupA and B. Only BRFS was significantly higher for Group avs. Group B.Table I. Group A Group B p-Value5-Year 10-Year 5-Year 10-Year survival survival survival survivalOS 86% 71% 83% 63% 0.65CSS 92% 92% 89% 79% 0.67BRFS 63% 58% 20% 20% 0.012OS, overal survival; CSS, cancer specific survival; BRFS, biochemicalrecurrence-free survival.Conclusion: RP provided good results in cT3-4 disease.PSA value at diagnosis in our series could not discriminateOSS and CSS, while BRFS was lower for patients with aPSA above 50 ng/ml. This study confirms that RP shouldbe considered as the first step in a multimodality approachfor locally advanced PC independently on PSA value atdiagnosis.References1 Van Poppel H and Joniau S: An analysis of radicalprostatectomy in advanced stage and high-grade prostatecancer. Eur Urol 53: 253-259, 2008.2 Gontero P, Marchioro G, Frea B et al: Is radicalprostatectomy feasible in all cases of locally advancednon-bone metastatic prostate cancer? Results of a single-institution study. Eur Urol 51: 922-930, 2007.3 Hsu CY, Joniau S, Oyen R, Roskams T and Van PoppelH: Outcome of surgery for clinical unilateral T3aprostate cancer: A single-institution experience. Eur Urol51(1): 121-128; discussion 128-129, 2007. Abstracts of the 20th Annual Meeting of SIUrO, Rome, June 23-25, 20101435

DO PATIENTS TREATED WITH RADICAL PROSTATECTOMY FOR LOCALLY ADVANCED PROSTATE CANCER AND PSA >50 ng/ml HAVE A WORSE PROGNOSIS THAN PATIENTS WITH PSA>20 ng/ml?

https://air.unimi.it/bitstream/2434/737364/2/ABST.SICA_6d.pdf

DO PATIENTS TREATED WITH RADICAL PROSTATECTOMY FOR LOCALLY ADVANCED PROSTATE CANCER AND PSA &gt;50 ng/ml HAVE A WORSE PROGNOSIS THAN PATIENTS WITH PSA&gt;20 ng/ml?

DO PATIENTS TREATED WITH RADICAL PROSTATECTOMY FOR LOCALLY ADVANCED PROSTATE CANCER AND PSA >50 ng/ml HAVE A WORSE PROGNOSIS THAN PATIENTS WITH PSA>20 ng/ml?

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AIR Universita degli studi di Milano

DO PATIENTS TREATED WITH RADICAL PROSTATECTOMY FOR LOCALLY ADVANCED PROSTATE CANCER AND PSA &gt;50 ng/ml HAVE A WORSE PROGNOSIS THAN PATIENTS WITH PSA&gt;20 ng/ml?

Abstract

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AIR Universita degli studi di Milano

DO PATIENTS TREATED WITH RADICAL PROSTATECTOMY FOR LOCALLY ADVANCED PROSTATE CANCER AND PSA >50 ng/ml HAVE A WORSE PROGNOSIS THAN PATIENTS WITH PSA>20 ng/ml?