Prostate cancer patients may expect better outcomes from surgery

June 03, 2001

ANAHEIM, June 3, 2001 -- A new study indicates that prostate cancer patients who have their prostate removed today have a better prognosis than patients who underwent the procedure ten years ago. Investigators at Memorial Sloan-Kettering Cancer Center will present this collaborative research at the American Urological Association meeting on June 3.

"The analysis demonstrates that prostate cancers found in today's patients respond much more favorably to surgery than what we have been able to predict prior to treatment," said Michael Kattan, PhD, researcher at Memorial Sloan-Kettering and senior author of the study. "Improved patient outcome may be due to earlier detection of less advanced cancers, improved surgical technique, or the ability to more accurately measure the prostate's clinical characteristics before surgery."

Researchers say these observations should have implications in future detection and treatment strategies, and may be one more factor patients consider when deciding among the various options available to address their disease. Radical prostatectomy, which involves removing the prostate as well as some tissue surrounding it, is the most common treatment of early-stage prostate cancer. In general, this option is offered to men who are younger than 70, have a life expectancy of at least 10 years, and whose cancer appears not to have spread beyond the prostate.

In order to determine the effect of surgery year on outcome, researchers retrospectively examined medical record information from 6,556 patients who had a radical prostatectomy between 1985 and 2000 at seven centers. They analyzed both pre-operative factors and post-surgical pathology information, including the clinical stage of the cancer, PSA level, Gleason score, margin status, and lymph node status.

When researchers took into account pre-operative information in the analysis, they found that the year in which patients underwent a radical prostatectomy was a good predictor of a patient's prognosis, which steadily improved in subsequent years of surgery. This effect vanished after the tumor was removed and doctors had a better sense of the cancer's clinical features, allowing for more accurate postoperative prognosis.

"Interestingly, once the prostate has been removed, more information about the extent and location of the tumor is available for predicting prognosis, so our postoperative outcome estimates remain on the mark when compared to our postoperative measurements for clinically identical patients from 10 years ago," said Dr. Kattan.

Nearly 60 percent of all prostate tumors are diagnosed at an early stage, when they are confined to the prostate gland. According to the American Cancer Society, the survival rate for all stages of prostate cancer combined has increased to 93 percent over the last 20 years, primarily because more men are being diagnosed at an earlier stage than in years past.
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The study was conducted by researchers at Memorial Sloan-Kettering Cancer Center; Baylor College of Medicine; The Cleveland Clinic Foundation - Cleveland; The Louisiana State University Health Science Center - Shreveport; The University Hospital Hamburg - Eppendorf; Erasmus University and Academic Hospital - Rotterdam; and The Garvan Institute of Medical Research and St. Vincent's Hospital - Sydney.

Memorial Sloan-Kettering Cancer Center is the world's oldest and largest institution devoted to prevention, patient care, research and education in cancer. Our scientists and clinicians generate innovative approaches to better understand, diagnose and treat cancer. Our specialists are leaders in biomedical research and in translating the latest research to advance the standard of cancer care worldwide.

Memorial Sloan Kettering Cancer Center

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