Pd61-04 Long-Term Oncological Outcomes of Surgically Managed Very High-Risk Prostate Cancer Patients According to the Stampede Trial Definition: Implications for the Selection of Candidates for Clinical Trials

You have accessJournal of UrologyProstate Cancer: Localized: Surgical Therapy IV (PD61)1 May 2024PD61-04 LONG-TERM ONCOLOGICAL OUTCOMES OF SURGICALLY MANAGED VERY HIGH-RISK PROSTATE CANCER PATIENTS ACCORDING TO THE STAMPEDE TRIAL DEFINITION: IMPLICATIONS FOR THE SELECTION OF CANDIDATES FOR CLINICAL TRIALS Antony Pellegrino, Simone Scuderi, Elio Mazzone, Armando Stabile, Leonardo Quarta, Alfonso Santangelo, Vito Cucchiara, Mattia Longoni, Pietro Scilipoti, Paolo Zaurito, Alice Mannazzu, Alessandro Viti, Francesco Barletta, Roberta Lucianò, Nazario Pio Tenace, Daniele Robesti, Riccardo Leni, Giorgio Gandaglia, Francesco Montorsi, and Alberto Briganti Antony PellegrinoAntony Pellegrino , Simone ScuderiSimone Scuderi , Elio MazzoneElio Mazzone , Armando StabileArmando Stabile , Leonardo QuartaLeonardo Quarta , Alfonso SantangeloAlfonso Santangelo , Vito CucchiaraVito Cucchiara , Mattia LongoniMattia Longoni , Pietro ScilipotiPietro Scilipoti , Paolo ZauritoPaolo Zaurito , Alice MannazzuAlice Mannazzu , Alessandro VitiAlessandro Viti , Francesco BarlettaFrancesco Barletta , Roberta LucianòRoberta Lucianò , Nazario Pio TenaceNazario Pio Tenace , Daniele RobestiDaniele Robesti , Riccardo LeniRiccardo Leni , Giorgio GandagliaGiorgio Gandaglia , Francesco MontorsiFrancesco Montorsi , and Alberto BrigantiAlberto Briganti View All Author Informationhttps://doi.org/10.1097/01.JU.0001009352.31737.3d.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In STAMPEDE trial, high-risk non-metastatic prostate cancer (PCa) men, treated with a radiotherapy (RT) plus androgen deprivation therapy (ADT) and eventual androgen receptor signaling inhibitors showed outstanding survival outcomes. However, a surgical arm (i.e., radical prostatectomy RP + extended lymph node dissection ePLND) was not included. METHODS: We relied on a cohort of 11,038 RP±ePLND treated patients at a single referral centre between 1986-2023. Among these, 558 very high-risk PCa patients according to STAMPEDE definition (node positive or node negative + ≥2 of the following: stage T3-T4, ISUP Grade Group 8–10, PSA≥40 ng/mL) were identified. Multimodal treatment (MMT) was defined as the use of any neoadjuvant or adjuvant treatment. Biochemical recurrence (BCR) was defined as 2 consecutive PSA≥0.2 ng/ml. High-grade (HG) complications were defined as Clavien-Dindo ≥2 within 90 days. Kaplan-Meier (KM) plots depicted BCR-free survival rates (FSR) after 5-year follow-up. Multivariable Cox regression (MCR) model assessed the predictors of BCR. Urinary continence (UC) and erectile function (EF) recovery were defined as the use of no pads over 24 hours and IIEF-EF score ≥21. RESULTS: Overall, 152 (27%) and 406 (73%) received surgery alone and MMT. Men who received surgery alone had more favorable pathology outcomes than MMT, with lower rates of pT≥3a (29 vs 71%), ISUP GG 4-5 (50 vs 61%) and lymph node invasion (19% vs 67%; all p0.1] recovery than surgery alone. CONCLUSIONS: A non-negligible number of very high-risk PCa patients treated with surgery alone have favorable pathological outcomes and are BCR-free after 5 years of follow-up. Randomized clinical trials are needed in this setting to identify very high-risk PCa men who can avoid MMT and can be cured with surgery alone. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1280 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Antony Pellegrino More articles by this author Simone Scuderi More articles by this author Elio Mazzone More articles by this author Armando Stabile More articles by this author Leonardo Quarta More articles by this author Alfonso Santangelo More articles by this author Vito Cucchiara More articles by this author Mattia Longoni More articles by this author Pietro Scilipoti More articles by this author Paolo Zaurito More articles by this author Alice Mannazzu More articles by this author Alessandro Viti More articles by this author Francesco Barletta More articles by this author Roberta Lucianò More articles by this author Nazario Pio Tenace More articles by this author Daniele Robesti More articles by this author Riccardo Leni More articles by this author Giorgio Gandaglia More articles by this author Francesco Montorsi More articles by this author Alberto Briganti More articles by this author Expand All Advertisement PDF downloadLoading ...