%0 Journal Article
%T Progresi車n metast芍tica, mortalidad c芍ncer espec赤fica y necesidad de tratamientos de segunda l赤nea en pacientes con c芍ncer de pr車stata de alto riesgo tratados inicialmente mediante prostatectom赤a radical
%A Rubio-Briones
%A J.
%A Iborra
%A I.
%A Trassierra
%A M.
%A Collado
%A A.
%A Casanova
%A J.
%A G車mez-Ferrer
%A A.
%A Ric車s
%A J.V.
%A Monr車s
%A J.L.
%A Dumont
%A R.
%A Solsona
%A E.
%J Actas Urol車gicas Espaˋolas
%D 2010
%I Scientific Electronic Library Online
%R 10.4321/S0210-48062010000700007
%X purpose: to determine our results in high risk (hr) prostate cancer (pca) patients treated with radical prostatectomy (rp) and to establish preoperative prognosis factors. material and methods: retrospective study of 925 rp. mean follow-up for the hr group was 89.8+/-53.6 months. following nccn criteria, we operated 210 (22.7%) hr and 715 (77.3%) low/intermediate risk patients. end point was metastatic progression. kaplan-meier method for survival comparison among groups and cox regression model for multivariate analysis of preoperative prognostic factors were used. results: revised period; 1986-2007. fifty-four patients (25.7%) were free of disease and 8 patients (3.8%) died for other causes free of disease. disease progressed in 148 patients (70.5%); death due to tumour progression occurred in 42 cases (20%) and due to other causes in 25 patients (11.9%). seventy-nine patients in hr group (38%) vs 549 low/intermediate risk group (78.5%) did not deserve further treatments (p<0.001). the uni and multivariate analysis for metastatic progression showed both gleason score at biopsy (rr=1.922; 95% ci 1.106-3.341, p=0.020) and clinical stage (rr=2.290; 95% ci 1.269-4.133, p=0.006) showed independent prognostic value for metastatic progression, but not psa. conclusions: a hr patient can be cured in a third of the cases and will need multimodal treatments in more than half of the times. we prompt surgery in a young healthy patient with a resectable tumour, mainly if just one bad prognostic factor is present and defiantly if this is just psa elevation.
%K death
%K gleason score
%K metastases
%K prediction
%K prostate cancer
%K psa
%K radical prostatectomy
%K risk groups
%K treatment failure.
%U http://scielo.isciii.es/scielo.php?script=sci_abstract&pid=S0210-48062010000700007&lng=en&nrm=iso&tlng=en