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The Effect of Risk Factors on Surgical and Oncological Results in High - Risk Prostate Cancer: A Multicenter Study of the Urooncology Society, Turkey
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  • Volkan Izol,
  • Nebil Akdogan,
  • Haluk Ozen,
  • Bulent Akdogan,
  • Ali Riza Kural,
  • Mustafa Tuna,
  • Sinan Sözen,
  • Levent Turkeri,
  • Mustafa Tansug
Volkan Izol
Cukurova University Faculty of Medicine
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Nebil Akdogan
Cukurova University Faculty of Medicine
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Haluk Ozen
Hacettepe University Faculty of Medicine
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Bulent Akdogan
Hacettepe University
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Ali Riza Kural
Acibadem Maslak Hastanesi
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Mustafa Tuna
Acibadem Saglik Grubu
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Sinan Sözen
Gazi University
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Levent Turkeri
Acibadem University
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Mustafa Tansug
Cukurova University Faculty of Medicine
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Abstract

Purpose To evaluate the effect of risk factors and selected surgical methods on operative and oncological results of patients undergoing radical prostatectomy (RP) with high-risk prostate cancer (HRPC). Methods Retrospective analysis of patients, who underwent RP for HRPC from 13 urology centers between 1990 to 2019, was performed. Groups were created according to the risk factors of D’Amico classification. Patients with one risk factor were included in group 1 where group 2 consisted of patients with two or three risk factors. Results A total of 1519 patients were included in this study and 1073 (70.6%) patients assigned to group 1 and 446 (29.4%) patients to group 2. Overall (biochemical and/or clinical and/or radiological) progression rate was 12.4% in group 1 and 26.5% in group 2 (p =0.001). Surgical procedure was open RP in 844 (55.6%) patients and minimally invasive RP in 675 (44.4%) patients (laparoscopic and robot-assisted RP in 230 (15.1%) and 445 (29.3%) patients, respectively). Progression rates were similar in different types of operations (p=0.22). Progression rate was not significantly different in patients who either underwent pelvic lymph node dissection (PLND) or not in each respective group. Conclusion RP alone is an effective treatment in the majority of patients with HRPC and PLND did not affect the progression rates after RP. According to the number of preoperative high-risk features, as the number of risk factors increases, there is a need for additional treatment.

Peer review status:ACCEPTED

13 Jan 2021Submitted to International Journal of Clinical Practice
15 Jan 2021Submission Checks Completed
15 Jan 2021Assigned to Editor
31 Jan 2021Reviewer(s) Assigned
17 Feb 2021Review(s) Completed, Editorial Evaluation Pending
10 Mar 20211st Revision Received
11 Mar 2021Assigned to Editor
11 Mar 2021Submission Checks Completed
11 Mar 2021Reviewer(s) Assigned
16 Mar 2021Review(s) Completed, Editorial Evaluation Pending
15 Apr 20212nd Revision Received
16 Apr 2021Submission Checks Completed
16 Apr 2021Assigned to Editor
23 Apr 2021Review(s) Completed, Editorial Evaluation Pending
26 Apr 2021Editorial Decision: Accept