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. 2024 Aug 1;5(9):885-892.
doi: 10.1002/bco2.414. eCollection 2024 Sep.

Long-term oncological outcomes after multimodal treatment for locally advanced prostate cancer

Fiorella L Roldan  1 , Ugo Giovanni Falagario  2   3 , Mats Olsson  2 , Rodolfo Sánchez Salas  2 , Markus Aly  2   4 , Lars Egevad  5 , Anna Lantz  2   4 , Henrik Grönberg  4 , Olof Akre  2 , Abolfazl Hosseini  2   6   7 , N Peter Wiklund  2   8
Affiliations

Long-term oncological outcomes after multimodal treatment for locally advanced prostate cancer

Fiorella L Roldan et al. BJUI Compass. .

Erratum in

  • Erratum.
    [No authors listed] [No authors listed] BJUI Compass. 2024 Dec 30;5(12):1324-1329. doi: 10.1002/bco2.482. eCollection 2024 Dec. BJUI Compass. 2024. PMID: 39744071 Free PMC article.

Abstract

Objective: The aim of this study is to evaluate treatment patterns and long-term oncological outcomes of patients with locally advanced prostate cancer (LAPCa).

Patients and methods: This is a population-based study including LAPC (cT3-4, M0) patients from the Stockholm region (Sweden). A sub-analysis was performed in men treated with primary cystoprostatectomy or total pelvic exenteration (TPE) for cT4 prostate cancer (PCa).Cox regression was used to identify predictors of overall mortality (OM) and cancer-specific mortality (CSM). Biochemical progression-free survival (BPFS) and 90 days complications were reported for the radical surgery subgroup.

Results: We included 2921 patients with cT3(N = 2713) or cT4(N = 208), M0 PCa diagnosed between 2003 and 2019. Out of these, 249(9%), 1497(51%) and 1175(40%) underwent radical prostatectomy, RT + ADT and androgen deprivation therapy (ADT), respectively. Survival rates were 76% (IQR: 68, 83), 47% (IQR: 44, 50) and 23% (IQR: 20, 27), respectively at 10 years. Irrespective of treatment modalities, cT4 patients had worse survival compared to cT3 patients (OM: HR1.44, IQR:1.17,1.77; PCSM: HR1.39, IQR:1.06,1.82). Twenty-seven patients with cT4, N0-1, M0 were treated with cystoprostatectomy or TPE. Twenty-two patients (81.5%) received neoadjuvant ADT. The 5-year BPFS, CSS and OS rates were 39.6%, 68.8% and 63.8%, respectively. Nine patients (33.3%) had Clavien-Dindo grade III and 1 (3.7%) grade IV complication within 90 days after surgery.

Conclusions: Pelvic surgery with radical intent as part of a multidisciplinary management may be an effective alternative for selected patients with locally advanced PCa leading to local tumour control and an acceptable morbidity.

Keywords: cancer‐specific survival; cystoprostatectomy; locally advanced prostate cancer; radical pelvic surgery; radiotherapy.

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Conflict of interest statement

None of the contributing authors have any conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter or materials discussed in the manuscript.

Figures

FIGURE 1
FIGURE 1
Overall survival and cancer‐specific survival of patients diagnosed with non‐metastatic locally advanced prostate cancer in the Stockholm region.
FIGURE 2
FIGURE 2
Overall survival, cancer‐specific survival and biochemical progression‐free survival of the Karolinska cohort.
See this image and copyright information in PMC

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