Prostate‐specific antigen levels of ≤4 and >4 ng/mL and risk of prostate cancer–specific mortality in men with biopsy Gleason score 9 to 10 prostate cancer

Cancer ◽  
2021 ◽  
Author(s):  
Daniel W. Kim ◽  
Ming‐Hui Chen ◽  
Jing Wu ◽  
Hartwig Huland ◽  
Markus Graefen ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Gleason Score ◽  
Specific Antigen ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Biopsy Gleason Score

Impact of the Percentage of Positive Prostate Cores on Prostate Cancer–Specific Mortality for Patients With Low or Favorable Intermediate-Risk Disease

2004 ◽  
Vol 22 (18) ◽  
pp. 3726-3732 ◽  
Author(s):  
Anthony V. D'Amico ◽  
Andrew A. Renshaw ◽  
Kerri Cote ◽  
Mark Hurwitz ◽  
Clair Beard ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Gleason Score ◽  
Cox Regression ◽  
Multivariable Analysis ◽  
Specific Antigen ◽  
Intermediate Risk ◽  
Conformal Radiation Therapy ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Biopsy Gleason Score

Purpose We investigated whether pretreatment factors predicted time to prostate cancer–specific mortality (PCSM) after conventional-dose and conformal radiation therapy (CRT). Patients and Methods Between 1988 and 2002, 421 patients with low (prostate-specific antigen [PSA] level ≤ 10 ng/mL and biopsy Gleason score ≤ 6) or favorable intermediate-risk (PSA > 10 to 15 ng/mL or biopsy Gleason score 3 + 4, but not both factors) disease underwent CRT (median dose, 70.4 Gy). Cox regression multivariable analysis was performed to determine whether the PSA level, Gleason score, T category, or the percentage of positive cores (% PC) predicted time to PCSM after CRT. After a median follow-up of 4.5 years, 117 (28%) patients have died. Results The % PC was the only significant predictor (Cox P ≤ .03). The relative risk of PCSM after CRT for patients with ≥ 50% as compared with less than 50% PC was 10.4 (95% CI, 1.2 to 87; Cox P = .03), 6.1 (95% CI, 1.3 to 28.6; Cox P = .02), and 12.5 (95% CI, 1.5 to 107; Cox P = .02) in men with a PSA ≤ 10 and Gleason score ≤ 6, PSA ≤ 10 and Gleason score ≤ 7, and PSA ≤ 15 and Gleason score ≤ 6, respectively. By 5 years after CRT, 5% to 9% compared with less than 1% (log-rank P ≤ .01) of these patients experienced PCSM if they had ≥ 50% compared with less than 50% PC, respectively. Conclusion CRT dose-escalation techniques, the addition of hormonal therapy, or both should be considered in the management of patients with low or favorable intermediate-risk disease and ≥ 50% PC.

Predictors of Prostate Cancer–Specific Mortality After Radical Prostatectomy or Radiation Therapy

2005 ◽  
Vol 23 (28) ◽  
pp. 6992-6998 ◽  
Author(s):  
Ping Zhou ◽  
Ming-Hui Chen ◽  
David McLeod ◽  
Peter R. Carroll ◽  
Judd W. Moul ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Radical Prostatectomy ◽  
Gleason Score ◽  
Specific Antigen ◽  
Study Cohort ◽  
Psa Failure ◽  
Specific Mortality ◽  
Cancer Specific Mortality ◽  
Biopsy Gleason Score

Purpose We evaluated predictors of prostate cancer–specific mortality (PCSM) after prostate-specific antigen (PSA) failure after radical prostatectomy (RP) or radiation therapy (RT). Patients and Methods A total of 1,159 men with clinically localized prostate cancer treated with RP (n = 498) or RT (n = 661) developed PSA failure, and they formed the study cohort. Competing risk 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 after PSA failure. The cumulative incidence method was used to estimate PCSM after PSA failure. Results A post-RP PSA-DT of less than 3 months (hazard ratio [HR], 54.9; 95% CI, 16.7 to 180), a post-RT PSA-DT of less than 3 months (HR, 12.8; 95% CI, 7.0 to 23.1), and a biopsy Gleason score of 8 to 10 (HR, 6.1; 95% CI, 3.4 to 10.7) for patients treated with RT were significantly associated with PCSM. Post-RP estimated rates of PCSM 5 years after PSA failure were 31% (95% CI, 17% to 45%) v 1% (95% CI, 0% to 2%) for patients with PSA-DT of less than 3 months v ≥ 3 months. Post-RT estimated rates of PCSM 5 years after PSA failure were 75% (95% CI, 59% to 92%) v 35% (95% CI, 24% to 47%) for patients with a biopsy Gleason score of ≥ 8 v ≤ 7, respectively, and PSA-DT of less than 3 months; these rates were 15% (95% CI, 0.8% to 28%) v 4% (95% CI, 1% to 6%), respectively, for patients with a PSA-DT ≥ 3 months. Conclusion Patients at high risk for PCSM after PSA failure can be identified based on post-RP PSA-DT or post-RT PSA-DT and biopsy Gleason score. These parameters may be useful in identifying patients for a randomized trial evaluating hormonal therapy with or without docetaxel.

Time to Prostate Specific Antigen Recurrence After Radical Prostatectomy and Risk of Prostate Cancer Specific Mortality

2006 ◽  
Vol 176 (4) ◽  
pp. 1404-1408 ◽  
Author(s):  
Stephen J. Freedland ◽  
Elizabeth B. Humphreys ◽  
Leslie A. Mangold ◽  
Mario Eisenberger ◽  
Alan W. Partin
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Specific Mortality ◽  
Cancer Specific Mortality

Cancer-Specific Mortality After Surgery or Radiation for Patients With Clinically Localized Prostate Cancer Managed During the Prostate-Specific Antigen Era

2003 ◽  
Vol 21 (11) ◽  
pp. 2163-2172 ◽  
Author(s):  
Anthony V. D’Amico ◽  
Judd Moul ◽  
Peter R. Carroll ◽  
Leon Sun ◽  
Deborah Lubeck ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Risk Groups ◽  
The United States ◽  
Localized Prostate Cancer ◽  
Institutional Setting ◽  
Psa Failure ◽  
Specific Mortality ◽  
Cancer Specific Mortality

Purpose: To determine whether pretreatment risk groups shown to predict time to prostate cancer–specific mortality (PCSM) after treatment at a single institution retained that ability in a multi-institutional setting. Patients and Methods: From 1988 to 2002, 7,316 patients treated in the United States at 44 institutions with either surgery (n = 4,946) or radiation (n = 2,370) for clinical stage T1c-2, N0 or NX, M0 prostate cancer made up the study cohort. A Cox regression analysis was performed to determine the ability of pretreatment risk groups to predict time to PCSM after treatment. The relative risk (RR) of PCSM and 95% confidence intervals (CIs) were calculated for the intermediate- and high-risk groups relative to the low-risk group. Results: Estimates of non-PCSM 8 years after prostate-specific antigen (PSA) failure were 4% v 15% (surgery versus radiation; Plog rank = .002) compared with 13% v 18% (surgery versus radiation; Plog rank = .35) for patients whose age at the time of PSA failure was less than 70 as compared with ≥ 70 years, respectively. The RR of PCSM after treatment for surgery-managed patients with high- or intermediate-risk disease was 14.2 (95% CI, 5.0 to 23.4; PCox < .0001) and 4.9 (95% CI, 1.7 to 8.1; PCox = .0037), respectively. These values were 14.3 (95% CI, 5.2 to 24.0; PCox < .0001) and 5.6 (95% CI, 2.0 to 9.3; PCox = .0012) for radiation-managed patients. Conclusion: This study provided evidence to support the prediction of time to PCSM after surgery or radiation on the basis of pretreatment risk groups for patients with clinically localized prostate cancer managed during the PSA era.

Prostate-specific antigen-based serial screening may decrease prostate cancer-specific mortality

Urology ◽  
2006 ◽  
Vol 68 (2) ◽  
pp. 342-347 ◽  
Author(s):  
Jason A. Efstathiou ◽  
Ming-Hui Chen ◽  
William J. Catalona ◽  
David G. McLeod ◽  
Peter R. Carroll ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Specific Mortality ◽  
Cancer Specific Mortality
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