Long-term autopsy findings following radical prostatectomy

Joseph E. Oesterling, Jonathan Ira Epstein, Patrick Walsh

Research output: Contribution to journalArticle

Abstract

In reviewing the Johns Hopkins Hospital records of over 1,000 radical prostatectomies performed since 1904, only 10 men have had a subsequent autopsy. All were managed by radical perineal prostatectomy without adjunctive therapy; 4 individuals had pathologic Stage B disease, and 6 men had pathologic Stage C cancer. The mean time interval between surgery and death was 8.9 years and 8.8 years for pathologic Stages B and C patients, respectively. Four patients (2 pathologic Stage B and 2 pathologic Stage C) had no evidence of disease, either local or distant, at autopsy. Two men (I pathologic Stage B and 1 pathologic Stage C) had only microscopic foci of local recurrence without distant metastases. Four other patients (1 pathologic Stage B and 3 pathologic Stage C) had bulky distant metastases; of these, 1 had no local disease, and 3 patients had only microscopic recurrence in the pelvis. No patient had gross pelvic recurrence, and no individual with microscopic local disease had symptoms secondary to that recurrence. Four patients (1 pathologic Stage B and 3 pathologic Stage C) died of prostatic cancer secondary to distant metastases. These data suggest: (1) radical prostatectomy alone provides excellent local control of the primary tumor, irrespective of the pathologic stage; (2) in patients where bulky metastatic disease was responsible for death, distant dissemination may have occurred prior to radical prostatectomy since all patients had either no pelvic disease or only microscopic local recurrence.

Original languageEnglish (US)
Pages (from-to)584-588
Number of pages5
JournalUrology
Volume29
Issue number6
DOIs
StatePublished - 1987

Fingerprint

Prostatectomy
Autopsy
Recurrence
Neoplasm Metastasis
Hospital Records
Pelvis
Neoplasms
Prostatic Neoplasms

ASJC Scopus subject areas

  • Urology

Cite this

Long-term autopsy findings following radical prostatectomy. / Oesterling, Joseph E.; Epstein, Jonathan Ira; Walsh, Patrick.

In: Urology, Vol. 29, No. 6, 1987, p. 584-588.

Research output: Contribution to journalArticle

@article{bb2cd205272a4594a41875e9b97602b5,
title = "Long-term autopsy findings following radical prostatectomy",
abstract = "In reviewing the Johns Hopkins Hospital records of over 1,000 radical prostatectomies performed since 1904, only 10 men have had a subsequent autopsy. All were managed by radical perineal prostatectomy without adjunctive therapy; 4 individuals had pathologic Stage B disease, and 6 men had pathologic Stage C cancer. The mean time interval between surgery and death was 8.9 years and 8.8 years for pathologic Stages B and C patients, respectively. Four patients (2 pathologic Stage B and 2 pathologic Stage C) had no evidence of disease, either local or distant, at autopsy. Two men (I pathologic Stage B and 1 pathologic Stage C) had only microscopic foci of local recurrence without distant metastases. Four other patients (1 pathologic Stage B and 3 pathologic Stage C) had bulky distant metastases; of these, 1 had no local disease, and 3 patients had only microscopic recurrence in the pelvis. No patient had gross pelvic recurrence, and no individual with microscopic local disease had symptoms secondary to that recurrence. Four patients (1 pathologic Stage B and 3 pathologic Stage C) died of prostatic cancer secondary to distant metastases. These data suggest: (1) radical prostatectomy alone provides excellent local control of the primary tumor, irrespective of the pathologic stage; (2) in patients where bulky metastatic disease was responsible for death, distant dissemination may have occurred prior to radical prostatectomy since all patients had either no pelvic disease or only microscopic local recurrence.",
author = "Oesterling, {Joseph E.} and Epstein, {Jonathan Ira} and Patrick Walsh",
year = "1987",
doi = "10.1016/0090-4295(87)90096-3",
language = "English (US)",
volume = "29",
pages = "584--588",
journal = "Urology",
issn = "0090-4295",
publisher = "Elsevier Inc.",
number = "6",

}

TY - JOUR

T1 - Long-term autopsy findings following radical prostatectomy

AU - Oesterling, Joseph E.

AU - Epstein, Jonathan Ira

AU - Walsh, Patrick

PY - 1987

Y1 - 1987

N2 - In reviewing the Johns Hopkins Hospital records of over 1,000 radical prostatectomies performed since 1904, only 10 men have had a subsequent autopsy. All were managed by radical perineal prostatectomy without adjunctive therapy; 4 individuals had pathologic Stage B disease, and 6 men had pathologic Stage C cancer. The mean time interval between surgery and death was 8.9 years and 8.8 years for pathologic Stages B and C patients, respectively. Four patients (2 pathologic Stage B and 2 pathologic Stage C) had no evidence of disease, either local or distant, at autopsy. Two men (I pathologic Stage B and 1 pathologic Stage C) had only microscopic foci of local recurrence without distant metastases. Four other patients (1 pathologic Stage B and 3 pathologic Stage C) had bulky distant metastases; of these, 1 had no local disease, and 3 patients had only microscopic recurrence in the pelvis. No patient had gross pelvic recurrence, and no individual with microscopic local disease had symptoms secondary to that recurrence. Four patients (1 pathologic Stage B and 3 pathologic Stage C) died of prostatic cancer secondary to distant metastases. These data suggest: (1) radical prostatectomy alone provides excellent local control of the primary tumor, irrespective of the pathologic stage; (2) in patients where bulky metastatic disease was responsible for death, distant dissemination may have occurred prior to radical prostatectomy since all patients had either no pelvic disease or only microscopic local recurrence.

AB - In reviewing the Johns Hopkins Hospital records of over 1,000 radical prostatectomies performed since 1904, only 10 men have had a subsequent autopsy. All were managed by radical perineal prostatectomy without adjunctive therapy; 4 individuals had pathologic Stage B disease, and 6 men had pathologic Stage C cancer. The mean time interval between surgery and death was 8.9 years and 8.8 years for pathologic Stages B and C patients, respectively. Four patients (2 pathologic Stage B and 2 pathologic Stage C) had no evidence of disease, either local or distant, at autopsy. Two men (I pathologic Stage B and 1 pathologic Stage C) had only microscopic foci of local recurrence without distant metastases. Four other patients (1 pathologic Stage B and 3 pathologic Stage C) had bulky distant metastases; of these, 1 had no local disease, and 3 patients had only microscopic recurrence in the pelvis. No patient had gross pelvic recurrence, and no individual with microscopic local disease had symptoms secondary to that recurrence. Four patients (1 pathologic Stage B and 3 pathologic Stage C) died of prostatic cancer secondary to distant metastases. These data suggest: (1) radical prostatectomy alone provides excellent local control of the primary tumor, irrespective of the pathologic stage; (2) in patients where bulky metastatic disease was responsible for death, distant dissemination may have occurred prior to radical prostatectomy since all patients had either no pelvic disease or only microscopic local recurrence.

UR - http://www.scopus.com/inward/record.url?scp=0023280395&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0023280395&partnerID=8YFLogxK

U2 - 10.1016/0090-4295(87)90096-3

DO - 10.1016/0090-4295(87)90096-3

M3 - Article

VL - 29

SP - 584

EP - 588

JO - Urology

JF - Urology

SN - 0090-4295

IS - 6

ER -