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Radical Prostatectomy Has Role in Management of High-Grade Prostate Cancer: Presented at EAU

By Jill Stein

MILAN, Italy -- March 26, 2008 -- Men treated with initial radical prostatectomy (RP) for high-grade prostate cancer have a median survival of nearly 12 years, according to data reported here at the 23rd Annual European Meeting of the Association of Urology (EAU).

Ryan Terlecki, MD, Chief Administrative Resident, Urology Division, Wayne State University/Karmanos Cancer Center, Detroit, Michigan, and associates reviewed overall survival outcomes in men followed for 10 years after undergoing initial RP for high-grade prostate cancer.

For their analysis, the investigators queried the Karmanos Cancer Center database for patients treated with initial RP for high-grade prostate cancer.

Overall, 145 patients were identified from 4 treatment groups: RP alone, RP plus androgen deprivation therapy, RP plus radiation, and RP plus radiation and androgen deprivation therapy.

The trial excluded patients who had received any form of cancer-directed therapy prior to surgery.

Mean age at surgery was 64 years, and median survival was 140 months.

Results showed that only age and African-American race were significant risk factors for worse survival, Dr. Terlecki said in a presentation on March 26.

In addition, adjuvant therapies beyond RP did not produce a significant survival benefit. "This finding highlights the importance of discretionary use of additional modes of treatment," Dr. Terlecki said.

The investigator cautioned that the results may be limited by the study's retrospective design. Also, there may have been a selection bias with regard to which patients were selected for surgery. In addition, they did not stratify their results by individual surgeon.

[Presentation title: Radical Prostatectomy as Monotherapy or as Part of Multimodal Management of High-Grade Prostate Cancer With 10-Year Minimum Follow-Up. Abstract 119]

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