Radical prostatectomy outcome when performed with PSA above 20 ng/ml.

摘要: Many centres currently do not offer radical prostatectomy (RP) to men with high-risk localised prostate cancer due concerns regarding poor outcome, despite evidence the contrary. We identified 18 undergoing RP serum PSA >20 ng/ml (high-risk by National Comprehensive Cancer Network definition) and minimum follow-up of 12 years (mean 13.5). Mean preoperative was 37.0 (Range 21.1-94.0). Prostatectomy pathology reported extracapsular disease in 16 (88.9%), positive surgical margins 15 (83%) pelvic lymph nodes 5 (27.8%). Overall cancer-specific survival at 10-years 83.3%, 88.2%, 72% 76.5% respectively. With complete 11 (61.1%) are alive, (27.8%) avoided any adjuvant therapy. Complete continence (defined as no involuntary urine leakage use pads) achieved 60%, partial remainder. conclude that surgery for this aggressive variant can result satisfactory outcome.