Subclassification of high-risk clinically organ-confined prostate cancer for early cancer-specific mortality after radical prostatectomy

High-risk clinically localized prostate cancer is seen in a highly heterogeneous population with a wide variation of clinical aggressiveness and a novel subclassification for the better prediction of clinical outcomes is needed. The aim of this study is to validate a modified D'Amico risk crite...

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Bibliographic Details
Published in:Japanese journal of clinical oncology 2016-08, Vol.46 (8), p.762-767
Main Authors: Kobayashi, Takashi, Kimura, Takahiro, Lee, Chunwoo, Inoue, Takahiro, Terada, Naoki, Kono, Yuka, Kamba, Tomomi, Kim, Choung-Soo, Egawa, Shin, Ogawa, Osamu
Format: Article
Language:English
Subjects:
Aged
Cohort Studies
Disease-Free Survival
Follow-Up Studies
Humans
Lymph Nodes - surgery
Male
Middle Aged
Neoplasm Recurrence, Local
Neoplasm Staging
Prostatectomy
Prostatic Neoplasms - mortality
Prostatic Neoplasms - pathology
Prostatic Neoplasms - surgery
Retrospective Studies
Risk
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Summary:High-risk clinically localized prostate cancer is seen in a highly heterogeneous population with a wide variation of clinical aggressiveness and a novel subclassification for the better prediction of clinical outcomes is needed. The aim of this study is to validate a modified D'Amico risk criteria for substratification of high-risk prostate cancer with regard to the prediction of biochemical recurrence, clinical progression-free survival or prostate cancer-specific mortality after radical prostatectomy. We conducted a retrospective multicenter cohort study including 461 clinically organ-confined (cT1-2), D'Amico high-risk prostate cancer patients who underwent radical prostatectomy with pelvic lymph node dissection. The modified criteria subclassified D'Amico high-risk patients into high-risk (n = 189, single high-risk parameter and two low-risk parameters) and very high-risk (n = 272, at least one more intermediate or high-risk parameter in addition to the qualifying high-risk parameter) groups. Biochemical recurrence-free survival, clinical progression-free survival, prostate cancer-specific mortality and overall survival were analyzed. The very high-risk group, compared with high-risk group, had significantly poorer biochemical recurrence (5- and 10-year biochemical recurrence-free rates: 52.8 vs 73.9% and 42.1 vs 61.7%, respectively, P
ISSN:0368-2811
1465-3621
DOI:10.1093/jjco/hyw061