• G S Gerber, R A Thisted, P T Scardino, H G Frohmuller, F H Schroeder, D F Paulson, A W Middleton, D B Rukstalis, J A Smith, P F Schellhammer, M Ohori, and G W Chodak.
• Section of Urology, Department of Surgery, University of Chicago (III) Pritzker School of Medicine, IL 60637, USA.
• JAMA. 1996 Aug 28; 276 (8): 615619615-9.

ObjectiveTo assess the results of radical prostatectomy in men with early prostate cancer.DesignRetrospective, nonrandomized, multi-institutional pooled analysis.SettingEight university medical centers in the United States and Europe.PatientsA total of 2758 men with stage Tl and T2 prostatic cancer.Main Outcome MeasuresDisease-specific and metastasis-free survival rates.ResultsTumor grade was the most important preoperative factor in determining outcome. Disease-specific survival 10 years following surgery and associated 95% confidence intervals were 94% (range, 87%-98%), 80% (range, 74%-85%), and 77% (range, 65%-86%) for those men with grade 1, 2, and 3 tumors, respectively. Metastasis-free survival at 10 years was 87% (range, 78%-92%), 68% (range, 62%-73%), and 52% (range, 38%-64%) for patients with grade 1, 2, and 3 cancers, respectively.ConclusionsRadical prostatectomy leads to high 10-year disease-specific survival rates in men with all tumor grades. However, caution is needed in comparing these results with similar studies of alternative treatment strategies, such as watchful waiting, due to the inherent potential biases in uncontrolled trials. Nevertheless, these results offer the best currently available estimates of 10-year outcome of radical prostatectomy in men with clinically localized prostate cancer and may be useful in counseling patients with early malignancy.

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