Surgery offers long-term survival for early stage prostate cancer patients
In the largest, most modern, single-institution study of its kind, Mayo Clinic urologists mined a long-term data registry for survival rates of patients who underwent radical prostatectomy for localized prostate cancer. The findings are being presented at the North Central Section of the American Urological Association's 84th Annual Meeting in Chicago.
A radical prostatectomy is an operation to remove the prostate gland and some of the tissue around it. In this study, Mayo Clinic researchers discovered very high survival rates for the 10,332 men who had the procedure between 1987 and 2004. This time period was chosen because it reflects the modern era of prostate cancer detection with the introduction of the prostate-specific antigen (PSA) test.
The researchers looked at overall survival, cancer-specific survival, progression-free survival and local recurrence at five to 20 years. Only 3 percent of patients died of prostate cancer. Five percent showed evidence of cancer spread to other organs and 6 percent had a local recurrence of cancer. Study participants had a median survival time of 19 years, and 8,000 are living to date. The mean and median follow-up period was 11 years.
"These are excellent survival rates," says R. Jeffrey Karnes, M.D., a Mayo Clinic urologist and senior author on the study. "They show that radical prostatectomy is a benchmark for treatment of men with prostate cancer that has not spread."
Radical prostatectomy was the primary treatment for the men. Studies done before the introduction of the PSA test showed less favorable survival results. Prior to the PSA test, prostate cancer was detected by symptoms or by a digital rectal exam (DRE), both of which were less likely to detect cancer before it had spread beyond the prostate.
"The findings are a testament to the individuals who have helped manage the database over the years, the many Mayo surgeons who performed the procedures with a similar approach and, ultimately, the patients," says Dr. Karnes.