Improvement of recurrence-free survival after radical prostatectomy for locally advanced prostate cancer in relation to the time of surgical intervention

Objective: to comparatively estimate the frequency of a positive surgical margin and 5-year biochemical recurrent-free survival (BRFS) rates in patients with locally advanced prostate cancer in relation to the time of radical retropubic prostatectomy. Subjects and methods. The investigation enrolled 274 patients with prostate cancer (pT3-4N0-1M0) who were divided into 2 groups of 68 and 20 patients operated on in 1997 to 2006 and 2007 to 2012, respectively. Two surgeons made surgical interventions by the standardized procedure. The 5-year BRFS rates were estimated using the Kaplan-Meier method and log-rank test. A biochemical recurrence was defined as a prostate-specific antigen level of >= 0.2 ng/ml in 2 consecutive measurements or as the initiation of adjuvant therapy. Results. The detection rate of a positive surgical margin decreased from 55.9 % in 1997-2006 to 37.9 % in 2007-2012 (p = 0.01); the 5-year recurrence-free survival rates were 38.8 % versus 66.2 % (p < 0.001). Conclusion. These changes would probably be a result of surgeons" better experience and improved surgical techniques in the course of time.