Clinicopathological outcome of radical retropubic prostatectomy for 200 men with prostate cancer in a single institution in Japan.

: The objective of this study was to retrospectively evaluate the clinicopathological outcome of radical retropubic prostatectomy (RRP) performed at a single institution in Japan. A consecutive series of 200 patients with prostate cancer who underwent RRP and pelvic lymphadenectomy between March 1985 and April 2003 were included in this study. The median age at RRP and the observation period were 69 years old and 43 months, respectively. Clinicopathological findings were reviewed to determine parameters providing predictive information about biochemical recurrence-free, cause-specific, and overall survivals. The pathological stage was pT0 in 7 patients (3.5%), pT2a in 43 (21.5%), pT2b in 58 (29.0%), pT3a in 42 (21.0%) pT3b in 36 (18.0%), and pT4 in 14 (7.0%). Lymph node metastasis was detected in 32 of 200 patients (16.0%). Forty-seven patients (23.5%) received neoadjuvant hormonal therapy, while 48 (24.0%) underwent hormonal therapy alone or hormonal therapy plus radiotherapy following RRP as an adjuvant treatment. During the observation period, 4 patients (2.0%) died of prostate cancer, 11 (5.5%) died of other diseases and biochemical recurrence occurred in 23 (11.5%), when biochemical recurrence was defined as prostate specific antigen (PSA) persistently greater than 0.4 ng/ml. Five-year biochemical recurrence-free, cause-specific, and overall survival rates were 83.6%, 97.7% and 91.4%, respectively. Furthermore, multivariate analyses showed that lymph node metastasis or clinical stage was an independent predictive factor for cause-specific or overall survival, respectively. These findings suggest that it would be possible to achieve a favorable cancer control for patients with localized prostate cancer, including locally advanced cases, by the RRP-based combination therapies.