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dc.contributor.authorAndersen, Sigveen_US
dc.contributor.authorRichardsen, Elinen_US
dc.contributor.authorNordby, Yngveen_US
dc.contributor.authorNess, Noraen_US
dc.contributor.authorStørkersen, Øysteinen_US
dc.contributor.authorAl-Shibli, Khaliden_US
dc.contributor.authorDønnem, Tomen_US
dc.contributor.authorBertilsson, Helenaen_US
dc.contributor.authorBusund, Lill-Toveen_US
dc.contributor.authorAngelsen, Andersen_US
dc.contributor.authorBremnes, Roy M.en_US
dc.date.accessioned2015-03-02T09:07:13Z
dc.date.available2015-03-02T09:07:13Z
dc.date.issued2014en_US
dc.description.abstractBackground Prostate cancer is the most common male malignancy and a mayor cause of mortality in the western world. The impact of clinicopathological variables on disease related outcomes have mainly been reported from a few large US series, most of them not reporting on perineural infiltration. We therefore wanted to investigate relevant cancer outcomes in patients undergoing radical prostatectomy in two Norwegian health regions with an emphasis on the impact of perineural infiltration (PNI) and prostate specific antigen- doubling time (PSA-DT). Methods We conducted a retrospective analysis of 535 prostatectomy patients at three hospitals between 1995 and 2005 estimating biochemical failure- (BFFS), clinical failure- (CFFS) and prostate cancer death-free survival (PCDFS) with the Kaplan-Meier method. We investigated clinicopathological factors influencing risk of events using cox proportional hazard regression. Results After a median follow-up of 89 months, 170 patients (32%) experienced biochemical failure (BF), 36 (7%) experienced clinical failure and 15 (3%) had died of prostate cancer. pT-Stage (p = 0.001), preoperative PSA (p = 0.047), Gleason Score (p = 0.032), non-apical positive surgical margins (PSM) (p = 0.003) and apical PSM (p = 0.031) were all independently associated to BFFS. Gleason score (p = 0.019), PNI (p = 0.012) and non-apical PSM (p = 0.002) were all independently associated to CFFS while only PNI (P = 0.047) and subgroups of Gleason score were independently associated to PCDFS. After BF, patients with a shorter PSA-DT had independent and significant worse event-free survivals than patients with PSA-DT > 15 months (PSA-DT = 3-9 months, CFFS HR = 6.44, p < 0.001, PCDFS HR = 13.7, p = 0.020; PSA-DT < 3 months, CFFS HR = 11.2, p < 0.001, PCDFS HR = 27.5, p = 0.006). Conclusions After prostatectomy, CFFS and PCDFS are variable, but both are strongly associated to Gleason score and PNI. In patients with BF, PSA-DT was most strongly associated to CF and PCD. Our study adds weight to the importance of PSA-DT and re-launches PNI as a strong prognosticator for clinically relevant endpoints.en_US
dc.identifier.citationBMC Urology 14(2014) nr. 1 s. -en_US
dc.identifier.cristinIDFRIDAID 1166362en_US
dc.identifier.doi10.1186/1471-2490-14-49en_US
dc.identifier.issn1471-2490en_US
dc.identifier.urihttps://hdl.handle.net/10037/7260
dc.identifier.urnURN:NBN:no-uit_munin_6843
dc.language.isoengen_US
dc.publisherBioMed Centralen_US
dc.rights.accessRightsopenAccess
dc.titleDisease-specific outcomes of Radical Prostatectomies in Northern Norway; A case for the impact of perineural infiltration and postoperative PSA-doubling timeen_US
dc.typeTidsskriftartikkelen_US
dc.typeJournal articleen_US
dc.typePeer revieweden_US


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