Anatomic radical retropubic prostatectomy—long-term recurrence-free survival rates for localized prostate cancer

Radical prostatectomy remains the mainstay for the treatment of localized prostate cancer. Long-term follow-up data showed excellent cancer control rates in several prostatectomy series. We report biochemical recurrence (BCR) outcomes after radical retropubic prostatectomy (RRP) in a European single center series of patients treated over a 13-year period. Between 1992 and 06/2005, 4,277 consecutive men underwent a RRP at the University Hospital Hamburg Eppendorf, Germany. Kaplan-Meier probabilities of BCR-free survival were determined for those patients with complete preoperative data, postoperative data, and follow-up information. Uni-and multivariate Cox regression models addressed PSA recurrence, defined as a PSA level ≥0.1 ng/ml. Overall, BCR-free survival ranged between 84, 70 and 61% for 2, 5, and 8 years, respectively. In univariate and multivariate analyses, except for age and type of nerve-sparing technique, all traditional clinical and pathological variables represented statistically independent predictors of PSA recurrence-free survival (all P≤0.001). In organ-confined disease, the 10-year recurrence free survival rate was 80 and 30% in non-organ-confined cancers. Our findings confirm excellent long-term biochemical cancer-control outcomes after RRP. High grade prostate cancer at final pathology and seminal vesicle invasion proved to be the strongest risk factors of BCR after surgery.