MAAUA: 2007 Abstracts - Natural History of Organ-Confined, Gleason ≤ 6 Prostate Cancer Following Radical Prostatectomy

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Natural History of Organ-Confined, Gleason ≤ 6 Prostate Cancer Following Radical Prostatectomy
David J Hernandez*, Matthew E Nielsen*, Misop Han, Bruce J Trock*, Alan W Partin, Patrick C Walsh, Jonathan I Epstein*
Johns Hopkins Medical Institutions, Baltimore, MD

Introduction: Men with organ-confined (OC), Gleason score ≤6 prostate cancer (PCa) are considered to have an excellent prognosis following surgery as definitive monotherapy. We determined the incidence of biochemical recurrence (BR), local recurrence (LR), distant metastasis (DM) and prostate-cancer specific mortality (PCSM) among this low-risk cohort.
Methods: A retrospective search of our radical prostatectomy database identified 6,081 men with OC, Gleason score ≤6 PCa treated between 1983 and 2005. Of these, 3,337 (54.9%) had adequate follow-up information and were assessed for BR, LR, DM, and PCSM. Pathologic specimens of men who progressed were re-evaluated by an experienced genitourinary pathologist, and patients who were upgraded or upstaged (28) were excluded from further analysis resulting in a final study cohort of 3,309. Actuarial probabilities of BR and LR were estimated using the Kaplan-Meier method.
Results: With a median follow-up of 3.0 years (range 1-22), BR occurred in 13 patients (0.4%). The 5-, 10- and 15-year actuarial probabilities of BR were 0.3%, 0.9%, and 1.3%, respectively. Five patients (0.2%) developed LR, four of whom received salvage radiotherapy with subsequently undetectable PSA. The 5-, 10-, and 15-year actuarial probabilities of LR were 0.1%, 0.5%, and 0.5%, respectively. There were no DMs and no PCSMs.
Conclusions: With postoperative follow-up on over 3,300 patients with OC, Gleason score ≤6 PCa, BR and LR following RP were extremely rare and no patients experienced DM or PCSM.

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