RESULTS OF RADICAL PROSTATECTOMY IN MEN WITH CLINICALLY LOCALIZED PROSTATE-CANCER - MULTIINSTITUTIONAL POOLED ANALYSIS

Objective.-To assess the results of radical prostatectomy in men with early prostate cancer. Design.-Retrospective, nonrandomized, multi-ins titutional pooled analysis. Setting.-Eight university medical centers in the United States and Europe. Patients.-A total of 2758 men with st age T1 and T2 prostatic cancer. Main Outcome Measures.-Disease-specifi c and metastasis-free survival rates. Results.-Tumor grade was the mos t important preoperative factor in determining outcome. Disease-specif ic survival 10 years following surgery and associated 95% confidence i ntervals were 94% (range, 87%-98%), 80% (range, 74%-85%), and 77% (ran ge, 65%-86%) for those men with grade 1, 2, and 3 tumors, respectively , Metastasis-free survival at 10 years was 87% (range, 78%-92%), 68% ( range, 62%-73%), and 52% (range, 38%-64%) for patients with grade 1, 2 , and 3 cancers, respectively. Conclusions.-Radical prostatectomy lead s to high 10-year disease-specific survival rates in men with all tumo r grades. However, caution is needed in comparing these results with s imilar studies of alternative treatment strategies, such as watchful w aiting, due to the inherent potential biases in uncontrolled trials, N evertheless, these results offer the best currently available estimate s of 10-year outcome of radical prostatectomy in men with clinically l ocalized prostate cancer and may be useful in counseling patients with early malignancy.