Five Year Results after Radical Prostatectomy in Patients with pT3a Patological Stage and Positive Surgical Margins

Abstract

Five year results in men with pT3a disease and positive surgical margins after radical retropubic prostatectomy were evaluated.

Materials and Methods

Between 1/90 and 12/98, 250 men underwent radical retropubic prostatectomy for prostate cancer. In 63 cases (25%) we found positive surgical margin. In these group 32 patients presented pathological stage T3a N0 with a Gleason score between 5 and 8. In 21 patients no adiuvant therapy was made while 11 patients underwent an adiuvant therapy (in 2 patients ormonal therapy, in 9 radiotherapy).

Results

The actuarial 5 years post prostatectomy biochemical, local and distant recurrence rates were 9%, 3% e 3 % respectively. For 21 men who didn't receive adiuvant therapy, 17 were biochemical recurrence free, in 3 cases a biochemical recurrence occurred, 1man underwent a radiotherapy of salvatage for a local recurrence. For 9 patients who received adiuvant radiation therapy, 8 are biochemical free while 1 presents metastatic desease at 5 years of follow-up. The 2 patients who received adiuvant hormonal therapy are biochemical recurrence free at 5 years.

Conclusions

The role of positive surgical margins on local recurrence of desease is still under debate. In our experience isolated local recurrence is rare during long term follow up of men with pT3a No stage and positive surgical margins at radica prostatectomy. The adiuvant radiotherapy seems to give a good local desease control at 5 years of follow-up.