Long-term biochemical disease-free and cancer-specific survival following anatomic radical retropubic prostatectomy - The 15-year Johns Hopkins experience

In a series of 2404 men who underwent anatomic radical prostatectomy with a mean follow-up of 6.3 years (range 1 to 17), the overall actuarial 5-, 10-, and 15-year recurrence-free survival rates for these men were 84%, 74%, and 66%, respectively. The actuarial likelihood of a postoperative recurrence increased with advancing clinical stage, Gleason score, and preoperative prostate-specific antigen (PSA) level, and pathologic stage. Subdivision of men with Gleason 7 tumors resulted in better stratification with similar actuarial likelihood of postoperative recurrence for men with Gleason (4+3) and Gleason score 8 to 10 diseases: however, recurrence rate in men with Gleason (3+4) diseases was statistically different from that of men with Gleason score 6 or Gleason (4+3) diseases. Excellent long-term results can be obtained with anatomic radical retropubic prostatectomy for men with clinically localized prostate cancer. The proportion of men with early stage prostate cancer will continue to increase with wide use of screening using serum PSA testing and digital rectal examination.