Local treatment characteristics and effectiveness for localized prostate cancer.

Aim: to evaluate the local treatment characteristics and effectiveness for localized prostate cancer. Objectives: 1. Evaluate demographics and disease characteristics of patients after radical prostatectomy from 2004-01-01 to 2016-02-29. 2. Assess the percentage of total operated patients who received radiotherapy. 3. Assess the time interval between the radiotherapy prior to prostatectomy. 4. Evaluate the overall and specific cancer survival. Methods: patient's medical documentation was collected retrospectively. Patients were chosen who had surgical treatment for prostate cancer and histological form adenocarcinoma was found. The diagnosis date was considered as the date of histological analysis response date. The statistical data and analysis was performed using MS Excel 2010 and SPSS 23.0 programs. Survival analysis was carried out, statistically significant difference between treatment groups was considered of p ≤ 0,05. Participants: LSMUL Kaunas clinics patients with prostate cancer who 2004-2016 underwent radical prostatectomy. We have investigated 2157 patients with prostate cancer confirmed by histologically. The study excluded who had history of other malignancies and metastatic disease. Results: we analyzed data of 2157 patients, average age was 62,99± 6,44 years. All patients received surgical treatment – radical prostatectomy. Mostly the primary tumour size by pathologist was estimated pT2c (56%), Gleason score 7 (63,19%), Gleason score sum 3+4 (52,6%). 66,6% of cases in the study lymph nodes were not assessed by pathologist (pNX). 578 patients (26,8%) underwent not radical prostatectomy (R1). 9% of patients had postoperative radiotherapy. Mostly (38,3%) radiotherapy after prostatectomy was applied in the period of 0-6 months. Overall 5-year survival of patients at age 60-69 were 92% and older than 69 year – 87,6%. Preoperative PSA did not statistically significant improved overall survival (p = 0,12). 5-year overall survival of II disease stage was 94,1% for stage III – 89,1%, Gleason score ≤ 7 – 93,7 %, Gleason score ≥ 8 – 79,1% R0 – 93,7%, RX/R1 – 85,7%. Conclusions: 5-year overall survival of prostate cancer patients were 92,4% and 5-years cancer specific survival – 98,3%. Older age, greater disease stage, positive surgical margins, greater Gleason score and extension into the lymph nodes statistically significant reduced survival. Recommendations: to ensure detailed preoperative testing and optimal treatment method