Adenocarcinoma can be successfully treated with radical prostate surgery

The authors aimed to determine long-term survival in patients with adenocarcinoma treated with radical prostatectomy.

Adenocarcinoma is the most common type of prostate cancer. It starts in the prostate gland and requires early treatment to prevent the cancer spreading. Radical prostatectomy is a form of treatment used that involves surgically removing the prostate from the patient.

Tumor staging is used to determine the extent of the initial tumor, grading it from lowest (T1-doctor cannot feel the tumor) to the highest (T4– cancer has spread outside the prostate). Gleason scores are also used as a grading system, comparing the differences between normal and cancer cells under the microscope. 

The aim of this study was to determine long-term survival in adenocarcinoma patients treated with radical prostatectomy.

30, 379 patients were used in this study who received radical prostatectomy.

Overall survival (the percentage of patients that are still alive) rates were as follows: 5-year survival of 92.8%, 10-year survival of 78.6% and 20-year survival of 38.6%.Cancer-specific survival (patients who did not die from cancer following treatment) rates were as follows: 5-year survival of 96.4%, 10-year survival of 89.5% and 20-year survival of 72.9%. 

Overall survival based on tumor staging was determined at 10 and 20-year intervals. T1 patients had a survival rate of 85.5% at 10-years and 41.4% at 20-years. T4 patients had a survival rate of 64.3% at 10-years and 28.6% at 20-years. Cancer-specific survival in T1 patients was 93.9% at 10-years and 84.1% at 20-years. Cancer-specific survival was 77.7% at 10-years and 61.6% at 20-years in T4 patients.

Overall survival in patients where the cancer had spread to the lymph nodes (sites that hold the immune cells) was 59.4% at 10-years and 25% at 20-years. Cancer-specific survival was 71.3% at 10-years and 47.9% at 20-years. Patients who had 0 infected nodes had a significantly increased overall survival of 81.1% at 10-years in comparison to patients with 4 or more infected nodes who had a 10-year 47.6% overall survival rate.

Patients who received additional treatments such as hormone therapy (targets the male sex hormones active in prostate cancer) or radiation had worse overall and cancer-specific survival rates in comparison to patients who did not receive the treatment. However, this may have been due to the fact that these patients would have presented with more aggressive forms of cancer at the beginning of the study. 

The authors concluded that long-term survival can be achieved with radical prostatectomy.

Due to the large number of patients used data interpretation may have varied throughout the samples leading to biased results.

If you are considering radical prostatectomy and would like more information on the benefits and risks involved please consult your doctor.