[Recurrent prostatic carcinoma after curative radiotherapy and radical prostatectomy]. 2003

D Pacík, and V Vít, and Z Beran
Urologická klinika FN Brno. dpacik@fnbrno.cz

BACKGROUND The authors evaluate indication criteria for individual therapeutic modalities of localized and locally advanced prostate cancer (CaP), but especially investigate progression of the disease in relation to CaP classification and other prognostic criteria. METHODS The paper evaluates 120 patients altogether, treated by curative radiotherapy (RT) and 115 patients who underwent radical retropubic prostatectomy (RAPE). The patients were followed according to age, PSA value, Gleason score and life prognosis. The Partin nomograms were used to evaluate probability of localized disease, locally advanced disease, the involvement of seminal vesicles (gonecysts) and lymphatic nodes. The patients were also stratified according to T-classification, patients after RAPE also according to pT classification. RESULTS RAPE: the mean period of observation was 37.9 month (6-114), 90 patients being without relapse (78.3%). A biochemical relapse occurred in 25 patients (21.7%). A local progression was confirmed by histology in 11 patients (44% of patients with progression, 9.6% of all patients after RAPE). RT: the mean period of observation was 26.75 months. A histological verification of the relapse was demonstrated in 14 patients (35.9% of patients with progression, 11.7% of all patients treated with RT). CONCLUSIONS No progression was detected (under comparable period of observation) in patients with lower mean PSA values, a lower Gleason score and a higher probability of localized disease. In contrast, detection of a progression of the disease is significantly higher in patients with higher PSA values, a higher mean value of the Gleason score, higher probability of the locally advance disease or involvement of seminal vesicles. In order to reach good results in the therapy of prostate cancer for long periods of time, the disease must be detected in time and the stage of the disease should be determined exactly with a maximum precision possible. The prognosis in patients with worse "input" parameters is worse from the long-term point of view and these indices should be carefully controlled.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009364 Neoplasm Recurrence, Local The local recurrence of a neoplasm following treatment. It arises from microscopic cells of the original neoplasm that have escaped therapeutic intervention and later become clinically visible at the original site. Local Neoplasm Recurrence,Local Neoplasm Recurrences,Locoregional Neoplasm Recurrence,Neoplasm Recurrence, Locoregional,Neoplasm Recurrences, Local,Recurrence, Local Neoplasm,Recurrence, Locoregional Neoplasm,Recurrences, Local Neoplasm,Locoregional Neoplasm Recurrences,Neoplasm Recurrences, Locoregional,Recurrences, Locoregional Neoplasm
D011468 Prostatectomy Complete or partial surgical removal of the prostate. Three primary approaches are commonly employed: suprapubic - removal through an incision above the pubis and through the urinary bladder; retropubic - as for suprapubic but without entering the urinary bladder; and transurethral (TRANSURETHRAL RESECTION OF PROSTATE). Prostatectomy, Retropubic,Prostatectomy, Suprapubic,Prostatectomies,Prostatectomies, Retropubic,Prostatectomies, Suprapubic,Retropubic Prostatectomies,Retropubic Prostatectomy,Suprapubic Prostatectomies,Suprapubic Prostatectomy
D011471 Prostatic Neoplasms Tumors or cancer of the PROSTATE. Cancer of Prostate,Prostate Cancer,Cancer of the Prostate,Neoplasms, Prostate,Neoplasms, Prostatic,Prostate Neoplasms,Prostatic Cancer,Cancer, Prostate,Cancer, Prostatic,Cancers, Prostate,Cancers, Prostatic,Neoplasm, Prostate,Neoplasm, Prostatic,Prostate Cancers,Prostate Neoplasm,Prostatic Cancers,Prostatic Neoplasm
D002277 Carcinoma A malignant neoplasm made up of epithelial cells tending to infiltrate the surrounding tissues and give rise to metastases. It is a histological type of neoplasm and not a synonym for "cancer." Carcinoma, Anaplastic,Carcinoma, Spindle-Cell,Carcinoma, Undifferentiated,Carcinomatosis,Epithelial Neoplasms, Malignant,Epithelioma,Epithelial Tumors, Malignant,Malignant Epithelial Neoplasms,Neoplasms, Malignant Epithelial,Anaplastic Carcinoma,Anaplastic Carcinomas,Carcinoma, Spindle Cell,Carcinomas,Carcinomatoses,Epithelial Neoplasm, Malignant,Epithelial Tumor, Malignant,Epitheliomas,Malignant Epithelial Neoplasm,Malignant Epithelial Tumor,Malignant Epithelial Tumors,Neoplasm, Malignant Epithelial,Spindle-Cell Carcinoma,Spindle-Cell Carcinomas,Tumor, Malignant Epithelial,Undifferentiated Carcinoma,Undifferentiated Carcinomas
D003131 Combined Modality Therapy The treatment of a disease or condition by several different means simultaneously or sequentially. Chemoimmunotherapy, RADIOIMMUNOTHERAPY, chemoradiotherapy, cryochemotherapy, and SALVAGE THERAPY are seen most frequently, but their combinations with each other and surgery are also used. Multimodal Treatment,Therapy, Combined Modality,Combined Modality Therapies,Modality Therapies, Combined,Modality Therapy, Combined,Multimodal Treatments,Therapies, Combined Modality,Treatment, Multimodal,Treatments, Multimodal
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D018450 Disease Progression The worsening and general progression of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important determinant of therapy and prognosis. Clinical Course,Clinical Progression,Disease Exacerbation,Exacerbation, Disease,Progression, Clinical,Progression, Disease

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