LONG-TERM ONCOLOGICAL RESULTS OF TREATMENT OF PATIENTS WITH HIGH-RISK PROSTATE CANCER (T3)

Purpose. To study long-term results of treatment and quality of life in patients with prostate cancer with clinical stage pT3.Material and methods. The study included 107 patients diagnosed with prostate cancer pT3a-bN0M0 G2-5. These are groups of patients who underwent surgical treatment with adjuvant radiation therapy (67 patients) and without it (40 patients). Such indicators of the quality of life after surgical treatment as urinary incontinence, urethral stricture, nocturia were studied. The localization of extraprostatic tumor spread was assessed as a predictor of survival. A comparison of the studied groups of patients in terms of survival rates using the Kaplan-Meier method with their comparison using a log-rank test was carried out.Results. Overall survival rates were statistically higher in the postoperative radiation therapy group (p = 0.021). Similar resultswere obtained when comparing cancer-specific survival (p = 0.044) and disease-free survival (p = 0.05). Adjuvant radiation therapy worsened the patients' quality of life (p <0.05). The best cancer prognosis is in patients with one risk factor for progression. When comparing subgroups with diffuse extraprostatic tumor spread, as well as with invasion into seminal vesicles, survival rates are higher in the group using radiation therapy (p <0.05). When comparing subgroups with focal extraprostatic tumor spread, no statistical difference was found (p> 0.05).Conclusion. Adjuvant radiation therapy significantly improves overall, cancer-specific survival and disease-free survival rates(p = 0.021, p = 0.044 and p = 0.05, respectively). At the same time, radiation therapy worsened the patients' quality of life. Patients with identified focal extraprostatic tumor spread did not have significant differences when using radiation therapy.

high risk prostate cancer, overall survival, disease-free survival, cancer-specific survival, the quality of life, riskfactors for progression, extraprostatic invasion

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