Remarkable long-term survival rates have recently been reported in locally advanced prostate cancers treated with radical prostatectomy . Similar findings have emerged in a large retrospective series of patients with prostate-specific antigen (PSA) over 20
|10-yr projected survival||All patients (n
|CDFS (local–distant recurrence)||47.5%||84.6%||9.7%||0.0003|
BDFS, biochemical disease free survival; CDFS, clinical disease free survival; CSS, cancer specific survival; OS, overall survival.
The finding of an 88% 10-yr projected cancer specific survival in this selected very high-risk prostate cancer population where radical surgery was administered alone or as part of a multimodal treatment is intriguing and deserves attention. While the beneficial role of surgery cannot be proven by our study design, the poor utility of PSA alone to predict the disease prognosis would seem clearly emphasized in this selected series. On the other hand, in the light of the known high probability of metastatic disease for PSA level above 100
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a University of Torino, Department of Urology, Torino, Italy
b University Hospital Leuven, Department of Urology, Leuven, Belgium
Corresponding author. Dipartimento di Discipline Medico Chirurgiche, University of Turin, Urologia 1, San Giovanni Battista Hospital, C.so Dogliotti, 14, Torino, Italy. Tel./Fax: +39 011 6335581; Mobile: 347 8600447.
© 2008 European Association of Urology, Published by Elsevier B.V.