Is Radical Prostatectomy Feasible in All Cases of Locally Advanced Non-Bone Metastatic Prostate Cancer? Results of a Single-Institution Study

Gontero, Paolo; Marchioro, G.; Pisani, R.; Zaramella, S.; Sogni, F.; Kocjancic, Ervin; Mondaini, Nicola; Bonvini, Daniele; Tizzani, A; Frea, Bruno

doi:10.1016/j.eururo.2006.08.050

Cited by 65 publications

(53 citation statements)

References 24 publications

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“…Gontero et al reported that operative time was significantly longer and the incidence of lymphocele was fourfold higher in the advanced disease series in comparison with cLD, supposedly as a result of extended lymphadenectomy. 7 However, in the current study, not only operative times, but also the incidence of lymphocele, were not statistically significant between the cLD and the cLAD groups. Two possible explanations are that we carried out only limited lympadenectomy and another is that we always ligate lymphatic vessels coming from the legs instead of clipping, because hemoclips have a tendency to be torn away during subsequent surgery.…”

Section: Discussioncontrasting

confidence: 40%

“…7,14,15 An 800 mL autologous blood donation 1-2 weeks before the operation since 1997 might greatly contribute to the result.…”

Section: Discussionmentioning

confidence: 99%

“…To our knowledge, there has been only one study examining the feasibility and safety of RP for cLAD to date. 7 In the current study, we assessed intraoperative and early postoperative (within 30 days after operation) complications of antegrade radical prostatectomy with intended wide resection (aRP) 6,8 for cLAD and comparing these complications with those for clinically localized prostate cancer (cLD) in the same periods; we investigated the feasibility and safety of aRP for cLAD.…”

Section: Introductionmentioning

confidence: 99%

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Feasibility of antegrade radical prostatectomy for clinically locally advanced prostate cancer: a comparative study with clinically localized disease

Yamamoto¹,

Kawakami²,

Yonese³

et al. 2010

Int J of Urology

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Objectives:To investigate intraoperative and early postoperative complications of antegrade radical prostatectomy with intended wide resection (aRP) for clinically locally advanced prostate cancer (cLAD) and to compare with those of aRP for clinically localized prostate cancer (cLD). Methods: Between March 1994 and June 2007, 800 consecutive Japanese patients including 625 with cLD and 175 with cLAD underwent aRP and bilateral limited lymphadenectomy. Clinicopathological data including intraoperative and early postoperative complications (within 30 days after operation) were compared between cLD and cLAD groups. Results: No deaths occurred. Operative time and blood loss did not differ significantly between the groups. Intraoperative and early postoperative complications were observed in 11 (1.4%) and 123 (15.4%) of the entire cohort, respectively. Prevalent early postoperative complications were pelvic hematoma, wound infection, urinary retention and lymphocele or prolonged lymph drainage. There were no significant differences in the entire intraoperative and early postoperative complications between the groups. The majority of the early postoperative complications were minor. Conclusions: aRP for cLAD is technically feasible and a safe surgical procedure. If radical prostatectomy could be established as a standard treatment for cLAD in the future, aRP might be valuable as the first step of multimodal treatments.

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Section: Discussioncontrasting

confidence: 40%

“…7,14,15 An 800 mL autologous blood donation 1-2 weeks before the operation since 1997 might greatly contribute to the result.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Feasibility of antegrade radical prostatectomy for clinically locally advanced prostate cancer: a comparative study with clinically localized disease

Yamamoto¹,

Kawakami²,

Yonese³

et al. 2010

Int J of Urology

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“…No study has provided persuasive evidence favoring one treatment modality over another. Radiation therapy has the advantage of avoiding the immediate morbidity of surgery, particularly since surgery for locally advanced cancers may be associated with a slightly higher complication rate than that for organ-confined cancers [22]. RP, compared with radiation therapy, may minimize late sequelae of local disease progression, although data supporting this conjecture are currently unavailable [23].…”

Section: Discussionmentioning

confidence: 99%

“…To identify high-risk cohorts we examined eight different definitions commonly used in the medical literature. Depending on the definition used, clinically high-risk patients had cancers that were organ-confined in 22[en]63% of cases and 5-yr probability of freedom from PSA relapse ranging from 49% to 80%. Moreover, of the high-risk patients who had disease recurrence, 25% (across all definitions) relapsed more than 2 yr after surgery, and in 26[en]39% the PSA doubling time at recurrence was ≥ 10 mo, both considered surrogates for a more protracted clinical course following biochemical recurrence (BCR) [5].…”

Section: Introductionmentioning

confidence: 99%

Secondary Therapy, Metastatic Progression, and Cancer-Specific Mortality in Men with Clinically High-Risk Prostate Cancer Treated with Radical Prostatectomy

et al. 2008

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Objectives-Commonly used definitions for high-risk prostate cancer identify men at increased risk of PSA relapse after radical prostatectomy (RP). We assessed how accurately these definitions identify patients likely to receive secondary cancer therapy, experience metastatic progression, or die of prostate cancer.Materials and methods-Among 5960 men with clinically localized or locally advanced prostate cancer who underwent RP, we identified eight different high-risk subsets, each comprising 4[en]40% of the study population. Estimates of freedom from radiation therapy, hormonal therapy, and metastatic progression after surgery were generated for each high-risk cohort with the Kaplan-Meier method, and hazard ratios (HR) were calculated with a Cox proportional hazards regression. The cumulative incidence and HR for prostate cancer[en]specific mortality (PCSM) were estimated with competing risk analysis.Results-Each of the studied high-risk criteria was associated with increased hazard of secondary cancer therapy (HR = 1.3[en]5.2, p < 0.05) and metastatic progression (HR = 2.1[en]6.9, p < 0.05). However, depending on the definition, the probability of freedom from additional therapy 10 yr after *Corresponding author. James A Eastham, MD, Department of Urology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021. Tel. 646-422-4390; Fax: 212-988-0759. E-mail address: easthamj@mskcc.org (J.A. Eastham). Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.I hereby certify that all authors have made a substantial contribution to the information or material submitted for publication, and have read and approved the final manuscript. None of the authors has direct or indirect commercial financial incentive associated with publishing the article. The manuscript or portions thereof are not under consideration by another journal or electronic publication and have not been previously published. Conclusions-Commonly used definitions for high-risk prostate cancer identify men at increased risk of secondary cancer therapy, metastatic progression, and PCSM following RP. However, a substantial proportion of high-risk patients remain free from additional therapy or metastatic disease many years after surgery. The risk of PCSM within 10 yr of treatment is remarkably low, even for patients at the highest risk of recurrent disease. Conflict of interests:

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Management of Localized and Locally Advanced Prostate Cancer

Tilki

Evans

2020

Urologic Principles and Practice

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Is Radical Prostatectomy Feasible in All Cases of Locally Advanced Non-Bone Metastatic Prostate Cancer? Results of a Single-Institution Study

Cited by 65 publications

References 24 publications

Feasibility of antegrade radical prostatectomy for clinically locally advanced prostate cancer: a comparative study with clinically localized disease

Feasibility of antegrade radical prostatectomy for clinically locally advanced prostate cancer: a comparative study with clinically localized disease

Secondary Therapy, Metastatic Progression, and Cancer-Specific Mortality in Men with Clinically High-Risk Prostate Cancer Treated with Radical Prostatectomy

Management of Localized and Locally Advanced Prostate Cancer

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