PROGRESSION IN AND SURVIVAL OF PATIENTS WITH LOCALLY ADVANCED PROSTATE-CANCER (T3) TREATED WITH RADICAL PROSTATECTOMY AS MONOTHERAPY

Purpose: We determine the progression and survival rates in patients w ith locally advanced prostate cancer treated with radical prostatectom y without adjuvant treatment, and investigate subgroups of patients wh o may not benefit from this treatment. Materials and Methods: Radical prostatectomy was performed in 83 patients with T3 prostate cancer. Th e patients were divided in subgroups with T3G1 to 2 and T3G3 tumors, w hich were evaluated for clinical progression, local recurrence, distan t metastases, biochemical progression, and overall and cancer specific survival at 5 and 10 years by Kaplan-Meier curves. The results were c ompared to those of 190 patients with locally confined tumors. Results : At 5 and 10 years overall survival was 75 and 60%, and cancer specif ic survival was 85 and 72%, respectively. At 5 and 10 years clinical p rogression was 41 and 69%, local recurrence 18 and 44%, and distant me tastases 31 and 50%, respectively. Biochemical progression at 5 years was 71%. Patients with poorly differentiated tumors showed significant ly lower survival and higher progression rates compared to those with well or moderately differentiated tumors. Progression and survival in patients with T3G1-2 tumor were not significantly different from those for patients with locally confined tumors. Conclusions: Radical prost atectomy as monotherapy in patients with locally advanced nonmetastati c prostate cancer (T3) produces acceptable results in those with well or moderately differentiated tumors. The results of progression and su rvival are not significantly different from those in patients with loc ally confined prostate cancer. However, patients with poorly different iated tumors (T3G3) have early progression and need adjuvant treatment following surgery.