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dc.contributor.authorAndersen, Sigve
dc.contributor.authorRichardsen, Elin
dc.contributor.authorNordby, Yngve
dc.contributor.authorNess, Nora
dc.contributor.authorStørkersen, Øystein
dc.contributor.authorAl-Shibli, Khalid
dc.contributor.authorDønnem, Tom
dc.contributor.authorBertilsson, Helena
dc.contributor.authorBusund, Lill-Tove
dc.contributor.authorAngelsen, Anders
dc.contributor.authorBremnes, Roy M.
dc.date.accessioned2015-02-19T21:07:32Z
dc.date.accessioned2015-05-27T13:36:21Z
dc.date.available2015-02-19T21:07:32Z
dc.date.available2015-05-27T13:36:21Z
dc.date.issued2014
dc.identifier.citationBMC Urology 2014, 14(1)nb_NO
dc.identifier.issn1471-2490
dc.identifier.urihttp://hdl.handle.net/11250/284112
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.nb_NO
dc.language.isoengnb_NO
dc.publisherBioMed Centralnb_NO
dc.titleDisease-specific outcomes of Radical Prostatectomies in Northern Norway; A case for the impact of perineural infiltration and postoperative PSA-doubling timenb_NO
dc.typeJournal articlenb_NO
dc.typePeer revieweden_GB
dc.date.updated2015-02-19T21:07:31Z
dc.source.volume14nb_NO
dc.source.journalBMC Urologynb_NO
dc.source.issue1nb_NO
dc.identifier.doi10.1186/1471-2490-14-49
dc.identifier.cristin1166362
dc.description.localcode© 2014 Andersen et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article unless otherwise stated.nb_NO


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