. Author manuscript; available in PMC: 2015 Jul 21.

Published in final edited form as: Nat Rev Clin Oncol. 2014 May 20;11(6):308–323. doi: 10.1038/nrclinonc.2014.68

Table 4. Large retrospective series of radical prostatectomy in high-risk patients demonstrates favorable 10-year prostate cancer–specific survival.

Author	Number high-risk patients	Definition of high-risk	Prostate cancer–specific survival (PCS)	Comments on population	Adjuvant therapy (adj)
Briganti, Joniau, et al., 2012⁷⁴	1366	PSA >20 or cT3 or bx Gl > 8	10 yr PCS 91% 10 yr 98% vs 88% in organ confined vs non-organ confines PCS	57% with cT3 75% with pT3-4 -adjuvant rx in 66.4% vs 16.8% in non-organ confined vs confined disease	48% received adj therapy (ADT +/- RT). -8.2% adj RT -29.7% adj ADT -10.2% adj RT+ADT
Boorjian, 2011⁷³	1238	PSA >20 or cT3 or bx Gl > 8	10 yrs PCS 92%	-33% cT3-4	-40% received adj therapy - 6.9% RT -29.5% ADT - 4.1% both RT and ADT)
Stephenson, 2009⁶⁵	1962	PSA >20 or cT3 or bx Gl > 8	10yr PCS 92% 15 yr PCS 81%	-large study, high risk represented 17% of overall population	-Adj therapy not reported
Ward, 2005⁷⁵	841	cT3	10yr PCS 90% 15yr PCS 79%	18% Gleason > 8 Mean PSA=10.2 (4.7-23.7)	-51% received adj RT -16% received adj ADT
Yossepowitch, 2008⁷⁶	1359 per D'Amico def'n 938 per NCCN def'n	8 high risk definitions compared	10yr PCS 93% per D'Amico 10yr PCM 92% per NCCN	-10yr cum incidence varied by definition (3-11%)	30-39% received ADT and/or RT within 5 yrs, but almost all at BCR/or salvage; no adj ADT and only 31cases of adj RT
Eggener, 2011⁶⁶	631 modeling/726 validation cohort	High risk per se not defined, but subset Gleason > 8subset reported	10yr PCS 82-87% for Gleason > 8	PCS by age: 70-79yo: 82% 60-69: 87% <60: 85%	-Adj therapy not reported
Spahn, 2010⁶⁷	712	PSA > 20ng/ml	10yr PCS estimated 89.8%	44% cT3-4 20% Gleason > 8	Adj RT varied by number of additional risk factors (11.9-21.6%) Adjuvant ADT similarly varied based on additional risk factors (35.4%-84.1%)
Zwergel, 2007⁶⁸	275	PSA > 20ng/ml	10 yr PCS 83%	75% also pT3 49% Gl > 8	-129/275 (47%) immediate ADT (almost all before yr 2000 when practice patterns changed at this single institution study) -Survival did not differ between immediate vs deferred ADT 2/275 adj RT (<1%)