RADICAL PROSTATECTOMY AS PRIMARY MONOTHER APY IN CAPSULAR-PENETRATINGPROSTATE-CANCER - RESULTS OVER 15 YEARS

Twenty-five patients with locally advanced prostate cancer (stage pT3p NO) underwent pelvic lymphadenectomy and radical pros tatectomy and we re followed up thereafter for at least 15 years. No hormonal treatment was given prior to tumor progression. Overall and disease-free 15-yea r survival rates were observed to be 44 and 24 %, respectively. These data suggest that a cure from prostate cancer by radical prostatectomy can be expected in a quarter of patients with capsular penetration. F rom our results, no justification can be derived to exclude radical pr ostatectomy from the spectrum of treatment options for patients with c apsular penetration of prostate cancer. More detailed analysis of the results depending on the local extent of the tumor and histological gr ade revealed distinct differences with respect to the risk of progress ion. Histological grade was the single most predictive parameter of pr ogression. Out of all subgroups of patients with capsular penetration of prostate cancer, those with a poorly differentiated tumor showed th e shortest progression-free interval after surgery, the highest level of overall progression and the largest proportion of tumor-related dea ths. By contrast, the prognosis was only slightly influenced by the pr esence or absence of seminal vesicle involvement. The role of adjuvant treatment after radical prostatectomy for patients with stage pT3pNO prostate cancer or for subgroups of them remains to be determined with in the scope of prospective randomized trials.