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Year 2011 Vol. 19 No 6

TRAUMATOLOGY AND ORTHOPEDICS

SH. KHALILOV, S.A. KRASNY, A.I. ROLEVICH

RISK OF CLINICAL PROGRESSION IN PATIENTS WITH PROSTATE CANCER WITH BIOCHEMICAL RECURRENCE AFTER RADICAL SURGICAL TREATMENT

Objectives. To determine predictors of clinical progression (CP) in patients with biochemical recurrence (BCR) of the prostate cancer (PC) after radical prostatectomy (RP).
Methods. Between 1997 and 2008, 483 patients with PC underwent open RP. Postoperatively in 172 patients BCR cases were diagnosed (38.5%). 34 patients of them were excluded from further analysis due to short follow-up (less than 3 months).In the remaining 138 patients 69 cases of CP were diagnosed. Overall, cancer-specific and progression-free survival in patients with BCR were calculated according to Kaplan-Meier method. Mono- and multivariate analyses with Cox proportional hazard model were performed.
Results. Only pathological Gleason score is found out to be of prognostic significance in the multivariate analysis (p <0,001). A model to predict the risk of CP was developed that permits to divide patients into 2 prognostic groups (low and high risk of CP).
Conclusions. Pathological Gleason sum is a predictor of CP in patients with BCR after RP. Early adjuvant hormonal therapy is recommended in patients of CP high risk (Gleason sum 8-10); and in low risk groups (Gleason sum 7 and less) – distant radiation therapy or observation.

Keywords: localized, locally-advanced prostate cancer, radical prostatectomy, biochemical recurrence, clinical progression
p. 88 – 94 of the original issue
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