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Klin Khir. 2014 Mar;(3):44-8.

[Far remote results of radical prostatectomy in patients suffering localized and locally advanced prostatic cancer].

[Article in Russian]

Abstract

Basing on analysis of results, obtained after conduction of radical prostatectomy for prostatic cancer (PC), there was stated, that an overall survival indices in terms of follow-up 3, 5 and 7 yrs have constituted (95.5 +/- 3.5), (84.1 +/- 4.7) and (71.7 +/- 6.8)%; and for the disease-free survival in the same terms--(87.05 +/- 3.20), (79.64 +/- 3.62) and (67.11 +/- 3.93)%; for the survival in terms up to 5 yrs in a localized PC--(97.18 +/- 3.27)%. In 48 (28.2%) patients a biochemical recurrence was revealed, for which the adjuvant therapy was administered. Statistically significant factors, permitting to prognosticate in patients, suffering PC stages T>T2 and biochemical recurrence, are the indices 7 points and more (in accordance to Glison scale), and initial level of a prostate speciphic antigen (PSA) 20 ng/ml and more, as well as their coincidence. Trustworthy increase of the disease recurrences rate was noted, when postoperatively a perineural invasion, positive tumoral margin and a lymph node affection were revealed. Presence of biochemical recurrence, positive surgical margin, perineural invasion and metastasis were associated with the enhanced risk of lethal outcome for the patients. Conduction of neoadjuvant hormonal therapy do not prevent a biochemical recurrence occurrence after conduction of radical prostatectomy. The tumoral process postoperative upstaging witnesses the necessity of the patients selection, owing unfavorable prognosis for administration of adjuvant hormonotherapy and radiation therapy, what impacts essentially positively a late results of surgical treatment. Application of a differentiated approach for the PC treatment permits to achieve high indices of survival in terms up to 5 yrs--(84.1 +/- 4.7)%.

PMID:
25098000
[Indexed for MEDLINE]

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