Recurrence Rare After Prostatectomy of Organ-Confined, Lower Grade Cancer

Men with organ-confined prostate cancer and a Gleason score of 6 or less very rarely have local or biochemical recurrence of disease 5 years after prostatectomy, according to study findings appearing in the July issue of Urology.

Among 2,526 such patients, there were 13 cases (0.5%) of biochemical recurrence and five cases (0.2%) of local recurrence after a median of 5 years of follow-up, report Dr. David J. Hernandez and associates at the Johns Hopkins Medical Institutions in Baltimore, Maryland.

There were no cases of distant metastases and there were no prostate cancer-specific deaths.

The five patients in the series who had local disease recurrence underwent salvage radiotherapy with subsequently undetectable PSA levels.

The 5-, 10- and 15-year actuarial probabilities of local recurrence were 0.1%, 0.5% and 0.5%, respectively, the Johns Hopkins team calculates. Corresponding probabilities of biochemical recurrence were 0.3%, 0.9% and 1.3%.

"The results of our study have demonstrated that, in the modern era, when prostate cancer is treated by the anatomic approach to radical prostatectomy with negative surgical margins and the tumor is organ-confined and lacks high-grade elements, it is effectively cured," Dr. Hernandez and colleagues conclude.

Urology 2008;72:172-176.

Reviewed by Ramaz Mitaishvili, MD


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