Radical prostatectomy: Long-term cancer control and recovery of sexual and urinary function ("trifecta") Journal Article
| Authors: | Bianco, F. J. Jr; Scardino, P. T.; Eastham, J. A. |
| Article Title: | Radical prostatectomy: Long-term cancer control and recovery of sexual and urinary function ("trifecta") |
| Abstract: | Radical prostatectomy (RP) disrupts the natural history of prostate cancer. However, it could be a significant source of long-term incontinence and potency morbidity. We studied the long-term cancer survival results and the probabilities of achieving ideal "trifecta" outcomes (cancer control, continence, and potency) after this surgical procedure. A total of 1746 intervention-naive patients with clinically localized newly diagnosed prostate cancer underwent RP with curative intent beginning in 1983. The mean follow-up time was 6 years (interquartile range, 3-9). The successive probabilities of achieving ideal trifecta outcomes for up to 24 months following RP versus experiencing biochemical recurrence were estimated using the cumulative incidence method. Additionally, long-term cancer control was assessed by preoperative and postoperative factors. Surgical excision controlled prostate cancer effectively in 1441 (83%) of the 1746 patients studied. At 5, 10, and 15 years, respectively, 82%, 77%, and 75% of patients were free from disease progression. Cancer-specific survival was 99%, 95% and 89%, respectively, at 5, 10, and 15 years. In men with disease progression, the 15-year probabilities of death from prostate cancer versus other causes were similar (32% and 33%, respectively). At 24 months, 60% of patients were potent, continent, and free of cancer, and 12% had experienced recurrence. Use of RP provided excellent long-term cancer control. At 15 years, only 11% of patients had died of prostate cancer. Cancer control was good even for patients with adverse prognostic features. The probability of death from cancer was similar to other causes after disease progression. By 2 years, 60% of men were continent, potent, and cancer free. © 2005 Elsevier Inc. All rights reserved. |
| Keywords: | cancer survival; surgical technique; recovery of function; major clinical study; disease course; cancer recurrence; postoperative care; preoperative care; follow up; follow-up studies; adenocarcinoma; time factors; prostate cancer; prostatic neoplasms; death; kidney function; probability; prostatectomy; remission induction; outcomes research; cancer control; biochemistry; continence; sexual function; penile erection; urination |
| Journal Title: | Urology |
| Volume: | 66 |
| Issue: | 5 Suppl. |
| ISSN: | 0090-4295 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2005-11-01 |
| Start Page: | 83 |
| End Page: | 94 |
| Language: | English |
| DOI: | 10.1016/j.urology.2005.06.116 |
| PUBMED: | 16194712 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 191" - "Export Date: 24 October 2012" - "CODEN: URGYA" - "Source: Scopus" |
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