Prostate cancer-specific mortality after radical prostatectomy for patients treated since the introduction of PSA.
November 1st, 2009 Posted in prostatectomyA multi-institutional study reports on prostate cancer (CaP)-specific mortality after radical prostatectomy (RP) treated since the introduction of PSA.
The study sought to establish a predictive nomogram and modeled the nomogram on 6,398 patients treated with RP at Baylor and Memorial Sloan-Kettering Cancer Center between 1987 and 2005. External validation of the nomogram was performed on 4,103 patients treated at the Cleveland Clinic and 2,176 patients treated at the University of Michigan. Patients were observed for disease recurrence and death was attributed to CaP using death certificates
In the modeling cohort, 117 patients died from CaP and 343 died from competing causes over a median follow-up of 48 months. The 15-year prostate cancer specific mortality was 12% and the all-cause mortality was 38%.
Multivariable analysis showed that primary and secondary biopsy Gleason grade 4 and 5 and increasing PSA were associated with prostate cancer specific mortality. Patients undergoing RP in more recent times had an improved prognosis. PSA velocity was not associated with prostate cancer specific mortality.
The study conclusions are available in the online edition of the Journal of Clinical Oncology,.