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Salvage radiation in men after prostate-specific antigen failure and the risk of death.

Publication ,  Journal Article
Cotter, SE; Chen, MH; Moul, JW; Lee, WR; Koontz, BF; Anscher, MS; Robertson, CN; Walther, PJ; Polascik, TJ; D'Amico, AV
Published in: Cancer
September 1, 2011

BACKGROUND: A survival benefit has been observed with salvage radiation therapy (RT) for prostate-specific antigen (PSA) failure after radical prostatectomy (RP) in men with rapid rises in PSA doubling time (DT, < 6 months). Whether such a benefit exits in men with a protracted PSA rise in DT (≥ 6 months) is unclear and was examined in the current study. METHODS: Of 4036 men who underwent RP at Duke University between 1988 and 2008, 519 experienced a PSA failure, had complete data, and were the subjects of this study. Univariate and multivariate Cox regression analyses were performed to evaluate whether salvage RT in men with either a rapid (< 6 months) or a protracted (≥ 6 months) PSA DT was associated with the risk of all-cause mortality adjusting for age at the time of PSA failure, known prostate cancer prognostic factors, and cardiac comorbidity. RESULTS: After a median follow-up of 11.3 years after PSA failure, 195 men died. Salvage RT was associated with a significant reduction in all-cause mortality for men with either a PSA DT of < 6 months (adjusted hazard ratio [AHR], 0.53; P = .02) or a PSA DT of ≥ 6 months (AHR, 0.52; P = .003). In a subset of patients with comorbidity data at the time of PSA failure, salvage RT remained associated with a significant reduction in all-cause mortality for both men with a PSA DT of < 6 months (AHR, 0.35; P = .042) or a PSA DT of ≥ 6 months (AHR, 0.60; P = .04). CONCLUSIONS: Salvage RT for PSA DTs less than or in excess of 6 months is associated with a decreased risk in all-cause mortality.

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Published In

Cancer

DOI

EISSN

1097-0142

Publication Date

September 1, 2011

Volume

117

Issue

17

Start / End Page

3925 / 3932

Location

United States

Related Subject Headings

  • Treatment Failure
  • Salvage Therapy
  • Risk Assessment
  • Retrospective Studies
  • Recurrence
  • Prostatic Neoplasms
  • Prostatectomy
  • Prostate-Specific Antigen
  • Oncology & Carcinogenesis
  • Middle Aged
 

Citation

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Cotter, S. E., Chen, M. H., Moul, J. W., Lee, W. R., Koontz, B. F., Anscher, M. S., … D’Amico, A. V. (2011). Salvage radiation in men after prostate-specific antigen failure and the risk of death. Cancer, 117(17), 3925–3932. https://doi.org/10.1002/cncr.25993
Cotter, Shane E., Ming Hui Chen, Judd W. Moul, W Robert Lee, Bridget F. Koontz, Mitchell S. Anscher, Cary N. Robertson, Philip J. Walther, Thomas J. Polascik, and Anthony V. D’Amico. “Salvage radiation in men after prostate-specific antigen failure and the risk of death.Cancer 117, no. 17 (September 1, 2011): 3925–32. https://doi.org/10.1002/cncr.25993.
Cotter SE, Chen MH, Moul JW, Lee WR, Koontz BF, Anscher MS, et al. Salvage radiation in men after prostate-specific antigen failure and the risk of death. Cancer. 2011 Sep 1;117(17):3925–32.
Cotter, Shane E., et al. “Salvage radiation in men after prostate-specific antigen failure and the risk of death.Cancer, vol. 117, no. 17, Sept. 2011, pp. 3925–32. Pubmed, doi:10.1002/cncr.25993.
Cotter SE, Chen MH, Moul JW, Lee WR, Koontz BF, Anscher MS, Robertson CN, Walther PJ, Polascik TJ, D’Amico AV. Salvage radiation in men after prostate-specific antigen failure and the risk of death. Cancer. 2011 Sep 1;117(17):3925–3932.
Journal cover image

Published In

Cancer

DOI

EISSN

1097-0142

Publication Date

September 1, 2011

Volume

117

Issue

17

Start / End Page

3925 / 3932

Location

United States

Related Subject Headings

  • Treatment Failure
  • Salvage Therapy
  • Risk Assessment
  • Retrospective Studies
  • Recurrence
  • Prostatic Neoplasms
  • Prostatectomy
  • Prostate-Specific Antigen
  • Oncology & Carcinogenesis
  • Middle Aged