Percentage of Cancer Volume in Biopsy Cores Is Prognostic for Prostate Cancer Death and Overall Survival in Patients Treated With Dose-Escalated External Beam Radiotherapy

2012 ◽  
Vol 83 (3) ◽  
pp. 940-946 ◽  
Author(s):  
Sean M. Vance ◽  
Matthew H. Stenmark ◽  
Kevin Blas ◽  
Schulyer Halverson ◽  
Daniel A. Hamstra ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
External Beam Radiotherapy ◽  
External Beam ◽  
Cancer Death ◽  
Prostate Cancer Death

Prostate-specific antigen (PSA) rate of decline post external beam radiotherapy predicts prostate cancer death

2013 ◽  
Vol 107 (2) ◽  
pp. 129-133 ◽  
Author(s):  
Zumin Shi ◽  
Carole B. Pinnock ◽  
Stephen Kinsey-Trotman ◽  
Martin Borg ◽  
Kim L. Moretti ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
External Beam Radiotherapy ◽  
Specific Antigen ◽  
External Beam ◽  
Cancer Death ◽  
Prostate Cancer Death ◽  
Rate Of Decline

scholarly journals Potential Risk of Other-Cause Mortality Due to Long-Term Androgen Deprivation Therapy in Elderly Patients with Clinically Localized Prostate Cancer Treated with Radiotherapy—A Confirmation Study

2020 ◽  
Vol 9 (7) ◽  
pp. 2296
Author(s):  
Hideya Yamazaki ◽  
Koji Masui ◽  
Gen Suzuki ◽  
Norihiro Aibe ◽  
Daisuke Shimizu ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Survival Rate ◽  
Elderly Patients ◽  
Androgen Deprivation Therapy ◽  
Potential Risk ◽  
External Beam Radiotherapy ◽  
External Beam ◽  
Cancer Specific Survival

Androgen deprivation therapy (ADT) is used to improve overall survival (OS) in prostate cancer treatment; however, we encountered that long-term ADT in elderly patients may be related to high other-cause mortality (OCM). This study aimed to confirm the potential risk associated with long-term ADT in elderly patients using a different large cohort. A comparison analysis was conducted between the ≥2- and <2-year ADT groups using open, large data from 1840 patients with clinically localized prostate cancer treated with radiotherapy (1172 treated with high-dose-rate brachytherapy (HDR) + external beam radiotherapy (EBRT) and 668 treated with external beam radiotherapy). The OCM-free survival (OCMFS), overall survival, and prostate cancer-specific survival rates were measured. The 10-year OCMFS rates in patients aged ≥75 years were 94.6% and 86% in the <2- and ≥2-year ADT groups, respectively, but were 96.3% and 93.5% (p = 0.0006) in their younger counterparts. If dividing into HDR and EBRT groups. This inclination was found in brachytherapy group but not in EBRT group. The overall survival rate was also lower in the elderly patients in the ≥2-year ADT group than in the <2-year ADT group; however, the 10-year prostate cancer-specific survival rate was the same in both groups. Long-term ADT in elderly patients resulted in not only higher OCM rates but also poorer OS rates; therefore, longer-term ADT in elderly patients should be performed with meticulous care.

Androgen deprivation therapy and overall survival for Gleason 8 versus Gleason 9-10 prostate cancer.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 23-23
Author(s):  
David Dewei Yang ◽  
Brandon Arvin Virgil Mahal ◽  
Vinayak Muralidhar ◽  
Neil E. Martin ◽  
Peter F. Orio ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Confidence Interval ◽  
Androgen Deprivation Therapy ◽  
Gleason Score ◽  
External Beam Radiotherapy ◽  
Androgen Deprivation ◽  
Hazard Ratio ◽  
Adjusted Hazard Ratio ◽  
External Beam

23 Background: While the addition of androgen deprivation therapy (ADT) to external beam radiotherapy is known to improve overall survival in Gleason 8-10 prostate cancer, it has been hypothesized that Gleason 9-10 disease, which is less differentiated than Gleason 8 disease, may be less sensitive to ADT. To investigate this idea, we examined the association between ADT and overall survival for Gleason 8 versus Gleason 9-10 prostate cancer. Methods: We identified 20,139 men in the National Cancer Database diagnosed with localized or locally advanced, Gleason 8-10 prostate cancer from 2004 through 2011 who received external beam radiotherapy. Patients with clinical evidence of nodal or metastatic disease were excluded. Cox proportional hazards regression was used to examine the association between ADT and overall survival. Results: Median follow-up was 4.0 years. 78.2% (9,509) of the 12,160 men with Gleason 8 disease and 86.6% (6,908) of the 7,979 men with Gleason 9-10 disease received ADT. On multivariable analysis, ADT was associated with a significant improvement in overall survival for Gleason 8 patients (adjusted hazard ratio 0.79, 95% confidence interval 0.71-0.88, P< 0.001) but not Gleason 9-10 patients (adjusted hazard ratio 0.96, 95% confidence interval 0.83-1.10, P= 0.532), with a significant interaction ( Pinteraction= 0.020). When considering Gleason 9-10 patients separately as Gleason 9 and Gleason 10, a higher Gleason score correlated with an increased adjusted hazard ratio for the association between ADT and overall survival ( Pinteraction= 0.012). Conclusions: In contrast to the significant survival advantage of ADT for Gleason 8 disease, our results strongly suggest that Gleason 9-10 disease may be less sensitive to ADT and that a higher Gleason score predicts lesser sensitivity. Consideration should be given to treatment intensification for Gleason 9-10 patients through enrollment in clinical trials or potentially adding novel antiandrogens or docetaxel, which have shown efficacy in both castration-resistant and castration-sensitive settings.

scholarly journals Both comorbidity and worse performance status are associated with poorer overall survival after external beam radiotherapy for prostate cancer

2020 ◽  
Author(s):  
Miikka Lehtonen ◽  
Lauri Heiskanen ◽  
Petri Reinikainen ◽  
Pirkko-Liisa Kellokumpu-Lehtinen
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Gleason Score ◽  
Biochemical Recurrence ◽  
External Beam Radiotherapy ◽  
Performance Status ◽  
Specific Antigen ◽  
External Beam ◽  
Free Survival ◽  
The Impact

Abstract Background: In this retrospective study, we evaluated the biochemical recurrence rate, metastatic disease progression, and prostate cancer-specific and overall survival in patients curatively treated with external beam radiotherapy (EBRT) for early prostate cancer (PC). We also examined the prognostic effect of comorbidity by Charlson Comorbidity Index (CCI) and overall performance status by Eastern Clinical Oncology Group (ECOG) score. Methods: A total of 665 men treated between 2008 and 2013 were enrolled from Tampere University Hospital, Finland. Prostate-specific antigen (PSA) tests and hospital records were used to determine the 5-year survival for each aforementioned endpoint using a Kaplan-Meyer estimate. To analyze the impact of the selected prognostic factor, we used a Cox regression model to calculate the corresponding hazard ratio (HR) and 95 % confidence interval (CI). Results: With a median follow-up-time of 7.12 years, the 5-year overall survival (OS) after EBRT was 88.9 % [86.5 %-91.3 %], prostate cancer-specific survival (PCSS) was 97.9 % [96.7 %-99.1%], metastasis-free survival (MFS) 94.8 % [93.0 %-96.6 %] and biochemical recurrence-free survival (BRFS) 88.7 % [86.2 %-91.2 %]. Both CCI (HR = 1.38, [1.25-1.51]) and ECOG score (HR = 1.63, [1.29-2.05]) declined OS, as well as Gleason score and T score (P < 0.05). Gleason score and T grade also associated to worse PCSS, MFS and BRFS. Conclusions: CCI and ECOG score are useful tools in evaluating the overall life expectancy of the patient after EBRT for PC. T-stage and Gleason score remain still the major prognostic factors.

scholarly journals Both comorbidity and worse performance status are associated with poorer overall survival after external beam radiotherapy for prostate cancer

2020 ◽  
Author(s):  
Miikka Lehtonen ◽  
Lauri Heiskanen ◽  
Petri Reinikainen ◽  
Pirkko-Liisa Kellokumpu-Lehtinen
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Gleason Score ◽  
Biochemical Recurrence ◽  
External Beam Radiotherapy ◽  
Performance Status ◽  
Specific Antigen ◽  
External Beam ◽  
Free Survival ◽  
The Impact

Abstract Background: In this retrospective study, we evaluated the biochemical recurrence rate, metastatic disease progression, and prostate cancer-specific and overall survival in patients curatively treated with external beam radiotherapy (EBRT) for early prostate cancer (PC). We also examined the prognostic effect of comorbidity by Charlson Comorbidity Index (CCI) and overall performance status by Eastern Clinical Oncology Group (ECOG) score. Methods: A total of 665 men treated between 2008 and 2013 were enrolled from Tampere University Hospital, Finland. Prostate-specific antigen (PSA) tests and hospital records were used to determine the 5-year survival for each aforementioned endpoint using a Kaplan-Meyer estimate. To analyze the impact of the selected prognostic factor, we used a Cox regression model to calculate the corresponding hazard ratio (HR) and 95 % confidence interval (CI). Results: With a median follow-up-time of 7.12 years, the 5-year overall survival (OS) after EBRT was 88.9 % [86.5 %-91.3 %], prostate cancer-specific survival (PCSS) was 97.9 % [96.7 %-99.1%], metastasis-free survival (MFS) 94.8 % [93.0 %-96.6 %] and biochemical recurrence-free survival (BRFS) 88.7 % [86.2 %-91.2 %]. Both CCI (HR = 1.38, [1.25-1.51]) and ECOG score (HR = 1.63, [1.29-2.05]) declined OS, as well as Gleason score and T score (P < 0.05). Gleason score and T grade also associated to worse PCSS, MFS and BRFS. Conclusions: CCI and ECOG score are useful tools in evaluating the overall life expectancy of the patient after EBRT for PC. T-stage and Gleason score remain still the major prognostic factors.

scholarly journals Both comorbidity and worse performance status are associated with poorer overall survival after external beam radiotherapy for prostate cancer

2019 ◽  
Author(s):  
Miikka Lehtonen ◽  
Lauri Heiskanen ◽  
Petri Reinikainen ◽  
Pirkko-Liisa Kellokumpu-Lehtinen
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Gleason Score ◽  
Biochemical Recurrence ◽  
External Beam Radiotherapy ◽  
Performance Status ◽  
External Beam ◽  
Z Score ◽  
Free Survival ◽  
The Impact

Abstract Purpose: In this retrospective study, we evaluated the biochemical recurrence rate, metastatic disease progression, and prostate cancer-specific and overall survival in patients curatively treated with external beam radiotherapy (EBRT) for early prostate cancer (PC). We also examined the prognostic effect of comorbidity by Charlson Comorbidity Index (CCI) and overall performance status. Methods: A total of 665 men treated between 2008 and 2013 were enrolled from Tampere University hospital, Finland. Prostate specific antigen (PSA) tests and hospital records were used to determine the 5-year survival for each aforementioned endpoint using a Kaplan-Meyer estimate. To analyze the impact of the selected prognostic factor, we used a Cox regression model to calculate the corresponding hazard ratio (HR) and 95 % confidence interval (CI). Results: With a median follow-up-time of 7.12 years, the 5-year overall survival (OS) after EBRT was 88.9 % [86.5 %-91.3 %], prostate cancer-specific survival (PCSS) was 97.9 % [96.7 %-99.1%], metastasis-free survival (MFS) 94.8 % [93.0 %-96.6 %] and biochemical recurrence-free survival (BRFS) 88.7 % [86.2 %-91.2 %]. Both CCI (HR = 1.38, [1.25-1.51]) and Z score (HR = 1.63, [1.29-2.05]) declined OS, as well as Gleason score and T grade (P < 0.05). Gleason score and T grade also associated to worse PCSS, MFS and BRFS. Conclusions and Implications for Cancer Survivors: CCI and Z score are useful tools in evaluating overall life expectancy of the patient after EBRT for PC. T-stage and Gleason score remain still the major prognostic factors. Keywords: Prostate Cancer; Radiotherapy; Treatment Outcome; Comorbidity; Physical Fitness

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