Elsevier

Urology

Volume 50, Issue 1, July 1997, Pages 93-99
Urology

Hazard rates for progression after radical prostatectomy for clinically localized prostate cancer*

https://doi.org/10.1016/S0090-4295(97)00106-4Get rights and content

Abstract

Objectives

We calculated the annual hazard rate (HR) for prostate cancer recurrence after radical prostatectomy (RP) to elucidate the pattern of treatment failure over time and to assess the efficacy of definitive therapy.

Methods

We calculated the progression-free probabilities (PFP) and HRs after RP for a cohort of 611 consecutive men with clinically localized (cT1–2, NX, MO) prostate cancer and no other treatment before documented progression.

Results

PFP for the entire study population was 78% at 5 and 76% at 10 years. The highest HR (0.09) was observed in the year immediately after surgery and dropped to 0 by year 7 (no patient recurred after year 6). Average annual HRs calculated for 3-year intervals resulted in steadily declining HRs over time for the entire study population and for all subsets, except those with a cancer pathologically confined to the prostate. Overall, the more ominous the prognostic factor, the higher the initial HR. For poorly differentiated cancers (biopsy Gleason sum 8 to 10), the HR was high in years 1 and 2 and dropped rapidly to 0 thereafter.

Conclusions

Prostate-specific antigen (PSA) progression after RP usually occurred early (77% within the first 2 years) and was largely due to understaging. Late recurrences were rare in patients who were regularly evaluated with PSA. However, because the confidence intervals in our study were broad, larger patient populations with longer follow-up are needed for a definitive establishment of the time, course, and pattern of recurrence after surgery. UROLOGY 50, 93-99, 1997.

References (24)

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    We observed a small but significant increase in PSA in the treatment group but not the reference group, and a lower frequency of BCR in the treatment group. Overall 15% of patients in the high risk treatment group had suspected BCR, lower than the 18% to 32% recurrence rate for patients not receiving TRT after RP during a comparable followup period.19–22 Moreover, the recurrence rate was higher in the high risk treatment group than in the high risk reference group, with no men with BCR in the nonhigh risk subgroups.

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*

Supported in part by grant CA58204 from the National Cancer Institute, U.S. Public Health Service for a SPORE in prostate cancer.

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