Early XXXX ablation for stage D1 (N1 to N3, M0) @entity263 : prognostic variables and outcome.

@entity1 @entity263 @entity5 @entity342 @entity1486
To elucidate the outcome for @entity1 with stage D1 (N1 to N3, M0) @entity263 we reviewed 179 @entity1 with lymphadenectomy proved pelvic nodal metastases who underwent immediate @entity342 ablation as the only initial treatment. With a median followup of 43 months, the 5 and 8-year actuarial rates of freedom from disease progression were 55% and 25%, respectively, and the median interval to disease progression was 67 months. The 5 and 8-year survival rates were 85% and 57%, respectively. Median survival after disease progression was 36 months. Local and distant disease progression was equally important. At 5 and 8 years the incidence of local progression was 32% and 51%, respectively, while metastatic rates at the same intervals wer 22% and 44%, respectively. Multivariate regression revealed that @entity5 grade and transurethral resection in preoperative stage C disease correlated with disease progression. Pretreatment @entity1486 ( @entity1486 ) levels were not predictive of outcome. The fact that transurethral resection predicted for local as well as distant failure suggests that the procedure selects for rather than aggravates adverse disease. Posttreatment @entity1486 levels were a sensitive index of response to treatment and of subsequent outcome. All @entity1 who failed to achieve undetectable @entity1486 levels had relapse by 8 years, whereas those whose levels became undetectable experienced only a 5% incidence of disease progression. These data show that @entity342 ablation alone is not curative for node positive disease but is associated with significant disease control and good short-term (5-year) survival. The @entity5 is an important source of @entity342 insensitive cells and comprehensive treatment strategies for this stage of disease require attention to the @entity5 as well as microscopic metastases.
