Predicting prostate cancer mortality among men with intermediate to high-risk disease and multiple unfavorable risk factors.

PURPOSE: To determine whether the number of unfavorable risk factors could be used to predict the risk of prostate cancer-specific mortality (PCSM) among men with intermediate- to high-risk prostate cancer. METHODS AND MATERIALS: We studied 1,063 men who underwent radical prostatectomy (n = 559), external beam radiotherapy (n = 288), or radiotherapy plus androgen suppression therapy (n = 116) for prostate cancer between 1965 and 2002. Fine and Gray's regression analysis was used to determine whether an increasing number of unfavorable risk factors (prostate-specific antigen level >10 ng/mL, Gleason score of >or=7, clinical Stage T2b or greater, or pretreatment prostate-specific antigen velocity >2.0 ng/mL/y) was associated with the interval to PCSM and all-cause mortality. RESULTS: Median follow-up was 5.6 years. Compared with those with one risk factor, the adjusted hazard ratio for PCSM was 2.3 (95% confidence interval 1.1-4.8; p = 0.03) for two risk factors, 5.4 (95% confidence interval 2.7-10.7; p

Duke Scholars

Author Judd Wendell Moul Urology