RADICAL PROSTATECTOMY FOR PATHOLOGICAL STAGE-C PROSTATE-CANCER - INFLUENCE OF PATHOLOGICAL VARIABLES AND ADJUVANT TREATMENT ON DISEASE OUTCOME

A retrospective analysis was performed on 1,035 patients with patholog ic Stage C prostate cancer treated with bilateral pelvic lymphadenecto my and radical retropubic prostatectomy. Of these patients, 661 receiv ed no immediate adjuvant treatment, 131 adjuvant radiotherapy only, an d 103 postoperative adjuvant orchiectomy only. Overall crude survival at five, ten, and fifteen years was 91 percent, 68 percent, and 46 per cent, respectively, comparable to the expected survival of 84 percent, 66 percent, and 46 percent, respectively. Cause-specific survival was 96 percent, 81 percent, and 66 percent and overall nonprogression sur vival was 78 percent, 56 percent, and 48 percent at five, ten, and fif teen years, respectively. Patients with margin-positive and residual d isease, high-grade tumors, large tumor bulk, and seminal vesicle invol vement were more likely to receive adjuvant treatment. However, both u nivariately and multivariately, only tumor grade and increasing tumor volume correlated significantly with cause-specific survival and local and systemic progression. Adjuvant treatment significantly decreased local, systemic, and overall progression but did not improve cause-spe cific or crude survival. Orchiectomy and radiation appeared to demonst rate similar efficacy in controlling local recurrences: five-year loca l recurrence-free survival in this retrospective analysis was > 95 per cent for both treatments compared with 84 percent for those without ad juvant treatment.