Abstract

Radical prostatectomy is the first choice treatment in organ confined prostate cancer with the advantage of ultimate cure. Almost half of cases have extraprostatic disease at pathologic evaluation and long-term follow up of 40% of cases display biochemical recurrence. The purpose of our study was to determine the relation between preoperative PSA, biopsy Gleason scores and the clinical stage with the recurrence of the disease after surgery. We have retrospectively evaluated 70 cases having undergone radical prostatectomy in our clinic between 1991 and 2000. The progression free survival rate was 73% and overall survival rate was 93% at a median follow up of 57 months. The mean preoperative PSA level was 17.8 ng/ml. There were 12 cases with a clinical stage of T1, 51 with T2a and 7 cases with T2b. There were 28, 34 and 8 cases for preoperative biopsy Gleason scores of 2-4, 5-6 and 7-10 respectively.

The PSA progression rate was 14%, 35% and 50% in cases with preoperative biopsy Gleason scores of 2-4, 5-6 and 7-10 respectively. The progression rate was 25% in 12 cases with cT1, 27 % in 51 cases with cT2a and 28 % in 7 cases with cT2b. The progression rates of the cases with preoperative PSA values of 0-9.9 ng/ml, 10-19.9 ng/ml and above 20 ng/ml were 5%, 26% and 48% respectively.

Clinical stage was not correlated with the progression rate, but the preoperative PSA level was found to be the best prognostic factor. Although a 43% downgrading was detected when comparing biopsy and specimen Gleason scores, these scores were still found to be correlated with the progression rates.