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Predictors of prostate cancer-specific mortality following radical prostatectomy or radiation therapy.

Publication ,  Journal Article
Zhou, P; Chen, MH; McLeod, D; Carroll, PR; Moul, JW; D'Amico, AV
Published in: J Clin Oncol
June 2005

4548 Background: PSA-defined recurrence as far out as 10 years following radical prostatectomy (RP) or radiation therapy (RT) for men with clinically localized prostate cancer occurs in up to 30% of cases. Yet a minority of these men will experience prostate cancer-specific mortality (PCSM). This study was performed to define the predictors of PCSM following PSA failure. METHODS: A total of 1159 men with clinically localized prostate cancer treated with RP (N = 498) or RT (N = 661) developed PSA failure and they formed the study cohort. The median follow-up was 5.9 and 5.2 years for the RP and RT groups, respectively. Cox regression analyses were used to evaluate whether previously identified predictors of time to metastasis including post-treatment PSA doubling time (PSA-DT), Gleason score, and interval to PSA failure could also predict time to PCSM following PSA failure. Cumulative incidence method was used to estimate PCSM following PSA failure. RESULTS: The post-treatment PSA-DT < 3 months after RP or RT and a biopsy Gleason score ≥ 8 in patients treated with RT were significantly associated with time to PCSM following PSA failure (Table). Postoperative estimates of PCSM (95% CI) 5 years following PSA failure were 31% (17-45%) versus 1% (0-2%) for patients with a PSA-DT < 3 months versus ≥ 3 months, respectively. Post-RT estimates of PCSM 5 years following PSA failure were 75% (59-92%) versus 35% (24-47%) for patients with a biopsy Gleason ≥ 8 versus ≤ 7 and a PSA-DT < 3 months; these estimates were 15% (0.8-28%) versus 4% (1-6%) for patients with a PSA-DT ≥ 3 months. CONCLUSIONS: Patients at high risk for PCSM following PSA failure can be identified based on the post-RP PSA-DT or the post-RT PSA-DT and biopsy Gleason score. These parameters identify the optimal patient selection for a randomized trial evaluating hormonal therapy with or without Taxotere. [Figure: see text] No significant financial relationships to disclose.

Duke Scholars

Published In

J Clin Oncol

EISSN

1527-7755

Publication Date

June 2005

Volume

23

Issue

16_suppl

Start / End Page

4548

Location

United States

Related Subject Headings

  • Oncology & Carcinogenesis
  • 1112 Oncology and Carcinogenesis
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Zhou, P., Chen, M. H., McLeod, D., Carroll, P. R., Moul, J. W., & D’Amico, A. V. (2005). Predictors of prostate cancer-specific mortality following radical prostatectomy or radiation therapy. J Clin Oncol, 23(16_suppl), 4548.
Zhou, P., M. H. Chen, D. McLeod, P. R. Carroll, J. W. Moul, and A. V. D’Amico. “Predictors of prostate cancer-specific mortality following radical prostatectomy or radiation therapy.J Clin Oncol 23, no. 16_suppl (June 2005): 4548.
Zhou P, Chen MH, McLeod D, Carroll PR, Moul JW, D’Amico AV. Predictors of prostate cancer-specific mortality following radical prostatectomy or radiation therapy. J Clin Oncol. 2005 Jun;23(16_suppl):4548.
Zhou, P., et al. “Predictors of prostate cancer-specific mortality following radical prostatectomy or radiation therapy.J Clin Oncol, vol. 23, no. 16_suppl, June 2005, p. 4548.
Zhou P, Chen MH, McLeod D, Carroll PR, Moul JW, D’Amico AV. Predictors of prostate cancer-specific mortality following radical prostatectomy or radiation therapy. J Clin Oncol. 2005 Jun;23(16_suppl):4548.

Published In

J Clin Oncol

EISSN

1527-7755

Publication Date

June 2005

Volume

23

Issue

16_suppl

Start / End Page

4548

Location

United States

Related Subject Headings

  • Oncology & Carcinogenesis
  • 1112 Oncology and Carcinogenesis
  • 1103 Clinical Sciences