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ISRN Oncology
Volume 2012 (2012), Article ID 596029, 6 pages
http://dx.doi.org/10.5402/2012/596029
Clinical Study

High-Grade Prostate Cancer: Favorable Results in the Modern Era Regardless of Initial Treatment

1The University of Texas Health Science Center San Antonio, 7703 Floyd Curl Drive MC7889, San Antonio, TX 78229, USA
2Department of Radiation Oncology, Radiology, and Urology, The University of Texas Health Science Center San Antonio, 7703 Floyd Curl Drive MC7889, San Antonio, TX 78229, USA
3Department of Epidemiology and Biostatistics, The University of Texas Health Science Center San Antonio, 7703 Floyd Curl Drive MC7889, San Antonio, TX 78229, USA
4Department of Urology, The University of Texas Health Science Center San Antonio, 7703 Floyd Curl Drive MC7889, San Antonio, TX 78229, USA

Received 21 September 2011; Accepted 27 October 2011

Academic Editors: A. Goussia, A. Sella, and L.-M. Sun

Copyright © 2012 Emma H. Ramahi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. We performed a retrospective study to determine the outcome of a modern cohort of patients with high-grade (Gleason score ≥ 8) prostate cancer treated with radical prostatectomy, radiation therapy, or hormone therapy. Methods. We identified 404 patients in the South Texas Veteran’s Healthcare System Tumor Registry diagnosed with high grade prostate cancer between 1998 and 2008. Mean follow-up was 4 . 6 2 ± 2 . 6 1 years. End points were biochemical failure-free survival, overall survival, metastasis-free survival, and cancer-specific survival. Results. 5-year overall survival for patients undergoing radical prostatectomy, radiation therapy, and hormone therapy was 88.9%, 76.3%, and 58.9%, respectively. 5-year metastasis-free survival for patients undergoing radical prostatectomy, radiation therapy, and hormone therapy was 96.8%, 96.6%, and 88.4%, respectively, and 5-year cancer-specific survival was 97.2%, 100%, and 89.9%, respectively. Patients with a Gleason score of 10 and pretreatment prostate-specific antigen > 20 ng/mL had decreased 5-year biochemical failure-free and cancer-specific survival. Patients with a pretreatment prostate-specific antigen > 20 ng/mL had decreased 5-year overall survival. Discussion. Even for patients with high-grade disease, the outcome is not as dire in the modern era regardless of primary treatment modality chosen. While there is room for improvement, we should not have a nihilistic impression of how these patients will respond to treatment.