Surgery for pathological T3a, T3b and lymph node positive prostate cancer: surgical, functional and oncological outcomes from a regional prostate cancer service
BAUS ePoster online library. Gilliland N. 06/24/19; 259543; P5-13
Mr. Niall Gilliland
Mr. Niall Gilliland
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Abstract
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INTRODUCTION

Surgery is increasingly employed as a treatment option for patients with high-risk prostate cancer. The present large UK contemporary study reports on the surgical, functional and oncological outcomes following surgery in these patients.

Patients and Methods
Patients with pathological T3a, T3b and N1 disease were extracted from our prospectively updated institutional database. Data includes demographics, preoperative cancer parameters, short- and long-term complications and functional results. Details of biochemical recurrence (BCR), type and oncological outcome of salvage treatments, cancer-specific (CSS) and overall survival (OS) was also obtained. Multivariate analysis was performed to determine factors for BCR post surgery and salvage treatment.

RESULTS

494 patients with complete data were obtained from with a median follow up of 4 years (range 2-10). 57%, 29% and 13% were staged as T3a, T3b and N1 respectively. Average inpatient stay was 1.7 days and overall complication rate was 11.36%. Complete continence or minor stress was seen in 82.6% and 89% reported significant ED. CSS and OS were 98.78% and 97.17 respectively. BCR was 36.71% with 82% and 39% receiving one or more than one salvage treatments respectively. Multivariate analyses demonstrate pathological stage is a predictor of BCR and immediate BCR is a predictor of failure of subsequent local salvage treatment (p<0.001).

Conclusions
Surgery is associated with encouraging surgical and functional outcomes, CSS and OS rates in these patients. Pathological stage is a significant predictor for BCR. The present analysis questions the effectiveness of further local salvage treatments in patients with an immediate BCR post operatively
INTRODUCTION

Surgery is increasingly employed as a treatment option for patients with high-risk prostate cancer. The present large UK contemporary study reports on the surgical, functional and oncological outcomes following surgery in these patients.

Patients and Methods
Patients with pathological T3a, T3b and N1 disease were extracted from our prospectively updated institutional database. Data includes demographics, preoperative cancer parameters, short- and long-term complications and functional results. Details of biochemical recurrence (BCR), type and oncological outcome of salvage treatments, cancer-specific (CSS) and overall survival (OS) was also obtained. Multivariate analysis was performed to determine factors for BCR post surgery and salvage treatment.

RESULTS

494 patients with complete data were obtained from with a median follow up of 4 years (range 2-10). 57%, 29% and 13% were staged as T3a, T3b and N1 respectively. Average inpatient stay was 1.7 days and overall complication rate was 11.36%. Complete continence or minor stress was seen in 82.6% and 89% reported significant ED. CSS and OS were 98.78% and 97.17 respectively. BCR was 36.71% with 82% and 39% receiving one or more than one salvage treatments respectively. Multivariate analyses demonstrate pathological stage is a predictor of BCR and immediate BCR is a predictor of failure of subsequent local salvage treatment (p<0.001).

Conclusions
Surgery is associated with encouraging surgical and functional outcomes, CSS and OS rates in these patients. Pathological stage is a significant predictor for BCR. The present analysis questions the effectiveness of further local salvage treatments in patients with an immediate BCR post operatively
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