Radical prostatectomy for cT3-4 disease: an evaluation of the pathological outcomes and patterns of care for adjuvant radiation in a national cohort.
Publication/Presentation Date
8-1-2011
Abstract
OBJECTIVE: • To use the Surveillance, Epidemiology and End Results Database to evaluate the pathological outcomes for patients with clinically staged T3-4 disease who undergo radical prostatectomy and to analyze whether these patients are receiving adjuvant radiation.
PATIENTS AND METHODS: • We identified patients who were clinically staged as having T3-4N0M0 prostate cancer and underwent radical prostatectomy between 2004 and 2006. Clinical data regarding preoperative prostate-specific antigen, as well as pathological Gleason score, were also collected. • Descriptive analyses were performed regarding the pathological extent of disease for these patients. • Logistic regression analysis was performed to identify unadjusted and adjusted predictors of radiation use for those with non-organ-confined disease or positive margins.
RESULTS: • A total of 718 patients were identified. Of these, 10.2% had organ-confined disease (8.1% with negative margins and 2.1% with positive margins). The median number of lymph nodes removed was three, with 9.9% of patients having pathologically positive lymph nodes. • The clinical accuracy of staging was found to be 81.4% for T3a, 77.4% for T3b and 70.1% for T4. Of those who had non-organ-confined disease or positive margins pathologically, 21.1% received adjuvant radiation. Logistic regression analysis revealed that those with Gleason 8-10 disease were most likely to receive adjuvant radiation.
CONCLUSIONS: • In this large series from a population-based cohort, clinical staging of T3-T4 disease was highly accurate in predicting pathological extent, with only 10.2% of patients found to have pathological T2 disease. • Most patients with confirmed pathological T3-T4 disease did not receive adjuvant radiation.
Volume
108
Issue
3
First Page
360
Last Page
365
ISSN
1464-410X
Published In/Presented At
Schreiber, D., Rineer, J., Sura, S., Teper, E., Nabhani, T., Han, P., Schwartz, D., Choi, K., & Rotman, M. (2011). Radical prostatectomy for cT3-4 disease: an evaluation of the pathological outcomes and patterns of care for adjuvant radiation in a national cohort. BJU international, 108(3), 360–365. https://doi.org/10.1111/j.1464-410X.2010.09875.x
Disciplines
Medicine and Health Sciences
PubMedID
21087395
Department(s)
Department of Surgery
Document Type
Article