BACKGROUND
No data exist on the patterns of biochemical recurrence (BCR) and their effect on survival in patients with high-risk prostate cancer (PCa) treated with surgery. The aim of our investigation was to evaluate the natural history of PCa in patients treated with radical prostatectomy (RP) alone.
MATERIALS AND METHODS
Overall, 2,065 patients with high-risk PCa treated with RP at 7 tertiary referral centers between 1991 and 2011 were identified. First, we calculated the probability of experiencing BCR after surgery. Particularly, we relied on conditional survival estimates for BCR after RP. Competing-risks regression analyses were then used to evaluate the effect of time to BCR on the risk of cancer-specific mortality (CSM).
RESULTS
Median follow-up was 70 months. Overall, the 5-year BCR-free survival rate was 55.2%. Given the BCR-free survivorship at 1, 2, 3, 4, and 5 years, the BCR-free survival rates improved by+7.6%,+4.1%,+4.8%,+3.2%, and+3.7%, respectively. Overall, the 10-year CSM rate was 14.8%. When patients were stratified according to time to BCR, patients experiencing BCR within 36 months from surgery had higher 10-year CSM rates compared with those experiencing late BCR (19.1% vs. 4.4%; P<0.001). At multivariate analyses, time to BCR represented an independent predictor of CSM (P<0.001).
CONCLUSIONS
Increasing time from surgery is associated with a reduction of the risk of subsequent BCR. Additionally, time to BCR represents a predictor of CSM in these patients. These results might help provide clinicians with better follow-up strategies and more aggressive treatments for early BCR.
Objectives To evaluate the temporal relationship between interval to biochemical recurrence (BCR) following radical prostatectomy (RP) and prostate cancer-specific mortality (PCSM).
Abstract Background Data regarding the natural history of biochemical recurrence (BCR) after radical prostatectomy (RP) and adjuvant radiotherapy (aRT) are limited. Objective To evaluate cancer-specific (CSM) and other-cause mortality (OCM) in prostate cancer patients with BCR after RP and aRT. Design, setting, and participants We identified 336 patients with BCR treated between 1990 and 2006 at two tertiary care centers. Intervention All patients underwent RP plus aRT. Outcome measurements and ...
Last. David F. Penson(Vandy: Vanderbilt University)H-Index: 80
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available at http://jurology.com/ Editorial Comment: In this article the authors use retrospective data from a representative cohort of men diagnosed with prostate cancer during a 12-month period to determine the relative rate of mortality in men undergoing radical prostatectomy or radiotherapy. As men selecting radiation and surgery are typically differing groups regarding age, disease stage, clinical risk factors and comorbid conditions, the authors use a technique called propensity scoring to...
Abstract Background Survival after surgical treatment using competing-risk analysis has been previously examined in patients with prostate cancer (PCa). However, the combined effect of age and comorbidities has not been assessed in patients with high-risk PCa who might have heterogeneous rates of competing mortality despite the presence of aggressive disease. Objective To examine the risk of 10-yr cancer-specific mortality (CSM) and other-cause mortality (OCM) according to clinical and pathologi...
Last. Ahmedin Jemal(ACS: American Cancer Society)H-Index: 139
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Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths expected in the United States in the current year and compiles the most recent data on cancer incidence, mortality, and survival based on incidence data from the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries and mortality data from the National Center for Health Statistics. A total of 1,660,290 new cancer cases an...
#2Zhaoyong Feng(NYU: New York University)H-Index: 25
Last. Stacy Loeb(NYU: New York University)H-Index: 68
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Purpose: Radical prostatectomy has decreased prostate cancer specific mortality in men with clinically localized prostate cancer. We report oncological outcomes of the longest running series of nerve sparing radical retropubic prostatectomy on the 30th anniversary of the inaugural operation.Materials and Methods: A total of 4,478 men underwent anatomical radical retropubic prostatectomy, as performed by a single surgeon (PCW), at the Johns Hopkins Medical Institutions from 1982 to 2011, without ...
Last. Hein Van Poppel(Katholieke Universiteit Leuven)H-Index: 26
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Background: Previous randomised trials demonstrated that adjuvant radiation therapy (aRT) improves cancer control in patients with pT3 prostate cancer (PCa). However, there is currently no evidence supporting early salvage radiation therapy (eSRT) as equivalent to aRT in improving freedom from biochemical recurrence (BCR) after radical prostatectomy (RP). Objective: To evaluate BCR-free survival for aRT versus observation followed by eSRT in cases of relapse in patients undergoing RP for pT3pN0,...
#2James A. Eastham(MSK: Memorial Sloan Kettering Cancer Center)H-Index: 107
Last. Kevin C. Zorn(UdeM: Université de Montréal)H-Index: 34
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Context: The optimal management strategy for men with newly diagnosed clinically localized prostate cancer remains a matter of debate. Numerous series have reported cancer control and quality-of-life (QoL) outcomes following treatment with radical prostatectomy (RP). Objective: Critically review published oncologic and functional outcomes after RP, and evaluate factors associated with these outcome measures. Evidence acquisition: A review of the literature was performed using the Medline and Web...
In 1966 Donald Gleason developed his grading and scoring system for prostatic adenocarcinoma. This classification was refined in 1974 and gained almost universal acceptance, being classified as a category 1 prognostic parameter by the College of American Pathologists. Modifications to the classification were recommended at a conference convened by the International Society of Urological Pathology (ISUP) in 2005. This modified classification has resulted in a significant upgrading of tumours, alt...
Study Type – Prognosis (cohort) Level of Evidence 2b What's known on the subject? and What does the study add? Patients with biochemical recurrence after prostatectomy often develop subsequent metastases. However, the natural history of metastatic progression in men who have not received subsequent therapies before developing metastases has been understudied. Here, we describe the largest known cohort of men with PSA-recurrent prostate cancer after prostatectomy who have not received additional ...
Het doel van deze studie was te onderzoeken of de bevindingen op een 18F‑DCFPyL PET/CT-scan leiden tot een verandering van het behandeladvies voor patienten met een biochemisch recidief (BCR) prostaatkanker. 253 patienten met BCR-prostaatkanker bij wie een 18F‑DCFPyL PET/CT-scan werd gemaakt ter herstadiering, werden geincludeerd. Twee urologen formuleerden een voorgestelde behandeling voor elke patient voor- en nadat zij kennis hadden genomen van de uitslagen van de 18F‑DCFPyL PET/CT-scan. Bij ...
BACKGROUND Prostate cancer (PCa) is the most frequent cancer in men. The prognosis of PCa is heterogeneous with many clinically indolent tumors and rare highly aggressive cases. Reliable tissue markers of prognosis are lacking. Active cholesteryl ester synthesis has been associated with prostate cancer aggressiveness. Sterol-O-Acyl transferases (SOAT) 1 and 2 catalyze cholesterol esterification in humans. OBJECTIVE To investigate the value of SOAT1 and SOAT2 tissue expression as prognostic marke...
Background: Radical prostatectomy (RP) is the standard treatment in patients with high-risk prostate cancer (PCa). However, there is a high rate of recurrence, and new approaches are required to improve surgical efficacy. Here, we evaluated the feasibility and safety of neoadjuvant chemohormonal therapy (NCHT) before RP for Japanese patients with high-risk localized prostate cancer (PCa). Methods: From February 2009 to April 2016, 21 high-risk patients were enrolled in this prospective study. Pa...
#1Alberto Martini(UniSR: Vita-Salute San Raffaele University)H-Index: 27
#2Nicola Fossati(UniSR: Vita-Salute San Raffaele University)H-Index: 36
Last. Alberto Briganti(UniSR: Vita-Salute San Raffaele University)H-Index: 96
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Abstract Intermediate clinical endpoints (ICEs) might aid in trial design and potentially expedite study results. However, little is known about the most informative ICE for patients receiving salvage radiation therapy (sRT) after radical prostatectomy. To investigate the most informative ICE for patients receiving sRT, we used a multi-institutional database encompassing patients treated at eight tertiary centers. Overall, 1301 men with node-negative disease who had not received any form of andr...
#1Snir Dekalo(Tel Aviv Sourasky Medical Center)H-Index: 4
#2Jonathan Kuten(Tel Aviv Sourasky Medical Center)H-Index: 5
Last. Roy Mano(Tel Aviv Sourasky Medical Center)H-Index: 3
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BACKGROUND High-risk prostate cancer is associated with adverse pathology and unfavorable outcomes after radical prostatectomy. 68Ga-PSMA PET/CT is more accurate than conventional imaging for preoperative staging. We aimed to evaluate whether lymph node involvement on 68Ga-PSMA PET/CT prior to radical prostatectomy in patients with high-risk prostate cancer is associated with worse short-term oncologic outcomes. METHODS We retrospectively reviewed 149 patients with high-risk localized or locoreg...
#1Niamh M Keegan(MSK: Memorial Sloan Kettering Cancer Center)H-Index: 2
#2Lisa Bodei(MSK: Memorial Sloan Kettering Cancer Center)H-Index: 25
Last. Michael J. Morris(MSK: Memorial Sloan Kettering Cancer Center)H-Index: 66
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CONTEXT Men with biochemically relapsed prostate cancer face a clinical conundrum. Depending on the detected distribution of disease, treatment goals may range from cure with focal therapy to palliative with systemic therapy to expectant observation. Retrospective studies of prostate-specific membrane antigen (PSMA)-based imaging demonstrate higher disease detection rates than conventional imaging. OBJECTIVE This review focuses on available prospective evidence for diagnostic use of PSMA-based i...
#1Dennie Meijer(VU: VU University Amsterdam)H-Index: 1
#1D. Meijer(VU: VU University Amsterdam)H-Index: 2
Last. André N. Vis(VU: VU University Amsterdam)H-Index: 8
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PURPOSE The aim of this study was to investigate whether an early, accurate identification of disease using 18F-DCFPyL PET/CT imaging resulted in a change of decision on treatment management, for individual patients with biochemically recurrent (BCR), hormone-sensitive prostate cancer. METHODS In this retrospective study, a total of 253 patients with BCR who underwent restaging 18F-DCFPyL PET/CT were assessed. Two urologists specialized in uro-oncology were asked to formulate a preferred treatme...
Last. Gregor Goldner(Medical University of Vienna)H-Index: 26
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PURPOSE To retrospectively evaluate the biochemical no evidence of disease (bNED) and late side effects after adjuvant radiotherapy in prostate cancer patients. METHODS Patients (n = 85) treated with external beam radiotherapy between 1997 and 2013 following radical prostatectomy (RPE) with pathological tumour stage pT2c with positive surgical margins or pT3 and pT4 tumours with or without positive margins who presented with a postoperative and a preradiation prostate-specific antigen (PSA) leve...