Risk Factors for Clinical Metastasis after Radical Prostatectomy and Adjuvant Androgen Deprivation Therapy

More than 1,112,000 patients worldwide were estimated to be diagnosed with prostate cancer (PC) in 2012, resulting in more than 307,000 deaths (Ferlay et al., 2013). In Japan, PC is the fourth, most commonly diagnosed cancer in men, with an estimated incidence of 51,534 cases (11.8% among 437,787 cancer patients of all primary sites) in 2008, and accounts for about 9,800 deaths annually in the latest data as of May 2014 (Matsuda et al., 2014). Most men diagnosed in the prostate-specific antigen (PSA) era have favorable disease characteristics that are curable by surgery or radiation therapy. However, the subset of men with high-grade (Gleason score [GS] ≥8) or extraprostatic disease (T3/T4 or lymph node involvement) have a risk of treatment failure as high as 70% when treated with surgery alone (Petrovich et al.,