The Effect of Risk Factors on Surgical and Oncological Results in High -
Risk Prostate Cancer: A Multicenter Study of the Urooncology Society,
Purpose To evaluate the effect of risk factors and selected surgical
methods on operative and oncological results of patients undergoing
radical prostatectomy (RP) with high-risk prostate cancer (HRPC).
Methods Retrospective analysis of patients, who underwent RP for HRPC
from 13 urology centers between 1990 to 2019, was performed. Groups were
created according to the risk factors of D’Amico classification.
Patients with one risk factor were included in group 1 where group 2
consisted of patients with two or three risk factors. Results A total of
1519 patients were included in this study and 1073 (70.6%) patients
assigned to group 1 and 446 (29.4%) patients to group 2. Overall
(biochemical and/or clinical and/or radiological) progression rate was
12.4% in group 1 and 26.5% in group 2 (p =0.001). Surgical procedure
was open RP in 844 (55.6%) patients and minimally invasive RP in 675
(44.4%) patients (laparoscopic and robot-assisted RP in 230 (15.1%)
and 445 (29.3%) patients, respectively). Progression rates were similar
in different types of operations (p=0.22). Progression rate was not
significantly different in patients who either underwent pelvic lymph
node dissection (PLND) or not in each respective group. Conclusion RP
alone is an effective treatment in the majority of patients with HRPC
and PLND did not affect the progression rates after RP. According to the
number of preoperative high-risk features, as the number of risk factors
increases, there is a need for additional treatment.