Long-term results of retropubic permanent 125iodine implantation of the prostate for clinically localized prostatic cancer

The Journal of Urology
M J Zelefsky, W F Whitmore

Abstract

The historical series of retropubic prostate radioactive source implantation from the Memorial Sloan-Kettering Cancer Center has served as the framework for the current transperineal implant approaches used in the treatment of localized prostatic cancer. We report the final assessment of the 15-year outcome. Between March 1970 and December 1987, 1,078 patients with biopsy proved adenocarcinoma of the prostate were treated at our cancer center with permanent implantation of 125iodine via a retropubic approach. In addition, all patients underwent bilateral pelvic lymphadenectomy before implantation. The clinical stages of disease were B1 in 234 patients (22%), B2 in 472 (44%), B3 in 145 (14%) and C in 227 (20%). Of the patients 733 (68%) had pathologically negative lymph nodes, whereas 345 (32%) had positive lymph nodes at lymph node dissection. Median followup was 11 years. Multivariate analysis identified nodal involvement, high grade disease, clinical stage B3/C and implant doses less than 140 Gy, as independent predictors of local relapse. Independent predictors of distant metastases included nodal involvement, stage B3/C disease and poorly differentiated histological status. The local recurrence-free survival rates for patie...Continue Reading

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