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RP - Long term outcome clinical statistics

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User
Posted 26 Jan 2017 at 07:47
Hi all,

I was hoping someone could point me in the direction of the most recent clinical statistics on outcomes from treatment of PCa with a RP.

Thanks in advance

Clare

User
Posted 27 Jan 2017 at 00:51

This is also useful reading http://www.baus.org.uk/patients/surgical_outcomes/radical_prostatectomy/

 

and this, although only small scale and the follow-up timeline was short. The vast majority of recurrences occur 2 - 5 years after surgery (although my dad's was 13 years later) http://roboticprostatesurgery.co.uk/wp-content/uploads/2015/09/Oncological-Outcomes-in-a-high-volume-UK-institution.pdf 

Edited by member 27 Jan 2017 at 00:58  | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 27 Jan 2017 at 00:39

https://www.mskcc.org/nomograms/prostate

This is the best way to work out your own likely outcomes - more reliable than looking at other people's data. MSK nomograms are taken from 000s of patients and are updated / adjusted regularly. Once you have put your OH's data in and got the predicted outcome, remember to adjust down a little though as results in the UK are slightly worse than in America.

Or instead of working it out yourself, you could ask the consultant to do it. Most hospital urology teams have their own version - so when John was diagnosed, the consultant we saw put all John's results in to the MSK nomogram, added in the adjustment for Leeds (lets say Leeds results are 10% worse, for example) and gave us the predicted outcomes for each treatment option. He also sent us that info in writing and the GP received a copy.

John was diagnosed with PSA 3.1, T1, clear scan and a small prostate. The nomogram predicted that he had a 55% chance of recurrence, which we thought must be a mistake. It wasn't.

Edited by member 27 Jan 2017 at 00:55  | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 27 Jan 2017 at 00:46

Salvage treatment - needed after the primary treatment was thought to have been successful but there has been a recurrence

Adjuvant treatment - secondary treatment either planned to combine with the primary treatment or recognised as necessary when the results of the primary treatment are seen.

Example: man has op, PSA stays low for 2 years and then rises. Surgery has failed so salvage RT is offered

Example: man has op, pathology indicates positive margin, adjuvant RT is offered

Example: man diagnosed with locally advanced, specialist recommends RP with adjuvant RT

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

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User
Posted 26 Jan 2017 at 11:56

For what category? You would need to set parameters such as outcomes for T1/2, outcomes for PSA <10, etc

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 26 Jan 2017 at 12:33

Ideally for low risk category PSa T1/T2 and PSA less than 10

However the stats overall for all PCa who are recommended and go ahead with the surgery

How many are 'cured' ..i.e PSA remains undetectable
How many need to have some form of 'salvage' treatment

I am not sure if I am using the term salvage appropriately

Regards

Clare

User
Posted 26 Jan 2017 at 12:53

Ideally for low risk category PSa T1/T2 and PSA less than 10

However the stats overall for all PCa who are recommended and go ahead with the surgery

How many are 'cured' ..i.e PSA remains undetectable
How many need to have some form of 'salvage' treatment

I am not sure if I am using the term salvage appropriately

Regards

Clare

User
Posted 27 Jan 2017 at 00:39

https://www.mskcc.org/nomograms/prostate

This is the best way to work out your own likely outcomes - more reliable than looking at other people's data. MSK nomograms are taken from 000s of patients and are updated / adjusted regularly. Once you have put your OH's data in and got the predicted outcome, remember to adjust down a little though as results in the UK are slightly worse than in America.

Or instead of working it out yourself, you could ask the consultant to do it. Most hospital urology teams have their own version - so when John was diagnosed, the consultant we saw put all John's results in to the MSK nomogram, added in the adjustment for Leeds (lets say Leeds results are 10% worse, for example) and gave us the predicted outcomes for each treatment option. He also sent us that info in writing and the GP received a copy.

John was diagnosed with PSA 3.1, T1, clear scan and a small prostate. The nomogram predicted that he had a 55% chance of recurrence, which we thought must be a mistake. It wasn't.

Edited by member 27 Jan 2017 at 00:55  | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 27 Jan 2017 at 00:46

Salvage treatment - needed after the primary treatment was thought to have been successful but there has been a recurrence

Adjuvant treatment - secondary treatment either planned to combine with the primary treatment or recognised as necessary when the results of the primary treatment are seen.

Example: man has op, PSA stays low for 2 years and then rises. Surgery has failed so salvage RT is offered

Example: man has op, pathology indicates positive margin, adjuvant RT is offered

Example: man diagnosed with locally advanced, specialist recommends RP with adjuvant RT

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 27 Jan 2017 at 00:51

This is also useful reading http://www.baus.org.uk/patients/surgical_outcomes/radical_prostatectomy/

 

and this, although only small scale and the follow-up timeline was short. The vast majority of recurrences occur 2 - 5 years after surgery (although my dad's was 13 years later) http://roboticprostatesurgery.co.uk/wp-content/uploads/2015/09/Oncological-Outcomes-in-a-high-volume-UK-institution.pdf 

Edited by member 27 Jan 2017 at 00:58  | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 27 Jan 2017 at 18:10

Thank you Lynn

That is fab

Regards

Clare

User
Posted 30 Jan 2017 at 13:25
Thanks for posting these. Very useful for me too.
User
Posted 30 Jan 2017 at 22:07
The surgeon that did mine is on this list and after 4 weeks since mine so far so good but I do appreciate it's early days and I'm extremely grateful to The NHS for doing this for me considering I was only diagnosed in early November
 
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