Long-term biochemical disease-free and cancer-specific survival following anatomic radical retropubic prostatectomy - The 15-year Johns Hopkins experience

In a series of 2404 men who underwent anatomic radical prostatectomy with a mean follow-up of 6.3 years (range 1 to 17), the overall actuarial 5-, 10- , and 15-year recurrence-free survival rates for these men were 84%, 74%, a nd 66%, respectively. The actuarial likelihood of a postoperative recurrenc e increased with advancing clinical stage, Gleason score, and preoperative prostate-specific antigen (PSA) level, and pathologic stage. Subdivision of men with Gleason 7 tumors resulted in better stratification with similar a ctuarial likelihood of postoperative recurrence for men with Gleason (4+3) and Gleason score 8 to 10 diseases: however, recurrence rate in men with Gl eason (3+4) diseases was statistically different from that of men with Glea son score 6 or Gleason (4+3) diseases. Excellent long-term results can be o btained with anatomic radical retropubic prostatectomy for men with clinica lly localized prostate cancer. The proportion of men with early stage prost ate cancer will continue to increase with wide use of screening using serum PSA testing and digital rectal examination.