EXTENDED EXPERIENCE WITH RADICAL PROSTATECTOMY FOR CLINICAL STAGE T3 PROSTATE-CANCER - OUTCOME AND CONTEMPORARY MORBIDITY

Purpose: Radical prostatectomy for clinical stage T3 prostate cancer h as not been widely accepted due to the potential for incomplete excisi on of the local tumor and high incidence of lymph node metastases. In addition, contemporary morbidity is unknown. We report the longterm re sults in 812 patients with clinical stage T3 prostate cancer treated w ith radical prostatectomy. Materials and Methods: Between 1966 and 199 2, 812 patients with clinical stage T3 prostate cancer underwent radic al prostatectomy of whom 479 (60%) received adjuvant therapy. Results: Mean patient age was 65 years (range 40 to 78). Mean followup was 4.5 years (range up to 24). Disease was stage pT2c or less in 17% of pati ents, pT3a to c in 49% and node-positive in 33%. Of the primary tumors pathological Gleason score was 7 or greater in 62%. Crude and cancer- specific survival rates at 5, 10 and 15 years were 86%, 70% and 51%, a nd 90%, 80% and 69%, respectively. Operative morbidity paralleled that of patients with clinically localized disease (T2c or less). Conclusi ons: An excellent survival rate with low treatment related morbidity c an be achieved by performing primary radical prostatectomy with adjuva nt therapy in the patient with clinical stage T3 prostate cancer.