scholarly journals Brachytherapy boost and cancer-specific mortality in favorable high-risk versus other high-risk prostate cancer

2016 ◽  
Vol 1 ◽  
pp. 1-6 ◽  
Author(s):  
Vinayak Muralidhar ◽  
Michael Xiang ◽  
Peter F. Orio III ◽  
Neil E. Martin ◽  
Clair J. Beard ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
High Risk Prostate Cancer ◽  
Specific Mortality ◽  
Risk Prostate Cancer ◽  
Brachytherapy Boost ◽  
Cancer Specific Mortality

Brachytherapy boost and cancer-specific mortality in favorable high-risk and other high-risk prostate cancer.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 52-52
Author(s):  
Vinayak Muralidhar ◽  
MIchael H. Xiang ◽  
Peter F. Orio ◽  
Neil E. Martin ◽  
Clair Beard ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Survival Benefit ◽  
Intermediate Risk ◽  
High Risk Prostate Cancer ◽  
High Risk Disease ◽  
Specific Mortality ◽  
Risk Prostate Cancer ◽  
Brachytherapy Boost ◽  
Cancer Specific Mortality

52 Background: A randomized trial has recently reported improved 5-year biochemical recurrence-free survival with brachytherapy (BT) boost compared with external beam radiation therapy (EBRT) boost in intermediate- to high-risk prostate cancer. Recent retrospective data suggest that BT boost may also confer a cancer-specific survival benefit in the high-risk subgroup. We sought to determine whether this survival benefit would extend to the recently defined favorable high-risk subgroup of prostate cancer patients (T1c, Gleason 4+4 = 8, PSA < 10 ng/mL or T1c, Gleason 6, PSA > 20 ng/mL). Methods: We identified 45,078 patients in the Surveillance, Epidemiology, and End Results database with cT1c-T3aN0M0 intermediate- to high-risk prostate cancer diagnosed 2004-2011 treated with EBRT or EBRT plus BT. We used multivariable competing risks regression to determine differences in the rate of prostate cancer-specific mortality (PCSM) after EBRT+BT or EBRT alone in patients with intermediate-risk, favorable high-risk, or other high-risk disease after adjusting for demographic and clinical factors. Results: BT boost was not associated with an improvement in 5-year PCSM compared with EBRT alone among patients with favorable high-risk disease (1.6% vs 1.9%; adjusted hazard ratio [AHR] 0.56; 95% confidence interval [CI], 0.21 to 1.52, P = 0.258) and intermediate-risk disease (0.7% vs 0.9%; AHR 0.83; 95% CI, 0.59 to 1.16; P = 0.270). Others with high-risk disease had significantly lower 5-year PCSM when treated with BT boost compared with EBRT alone (3.9% vs 5.0%; AHR 0.73; 95% CI, 0.55 to 0.95; P = 0.022). Conclusions: Brachytherapy boost is associated with a decreased rate of PCSM in men with high-risk prostate cancer, but this benefit was not seen among patients with favorable high-risk disease. This suggests that the recently-defined “favorable high-risk” category may be used to personalize therapy for men with high risk disease.

Impact of percent positive biopsy cores on cancer-specific mortality for patients with high-risk prostate cancer

2020 ◽  
Vol 38 (9) ◽  
pp. 735.e9-735.e15
Author(s):  
David D. Yang ◽  
Vinayak Muralidhar ◽  
Brandon A. Mahal ◽  
Marie E. Vastola ◽  
Ninjin Boldbaatar ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
High Risk Prostate Cancer ◽  
Positive Biopsy ◽  
Specific Mortality ◽  
Risk Prostate Cancer ◽  
Cancer Specific Mortality

scholarly journals Prostate cancer-specific mortality and the extent of therapy in healthy elderly men with high-risk prostate cancer

Cancer ◽  
2010 ◽  
Vol 116 (11) ◽  
pp. 2590-2595 ◽  
Author(s):  
Karen E. Hoffman ◽  
Ming-Hui Chen ◽  
Brian J. Moran ◽  
Michelle H. Braccioforte ◽  
Daniel Dosoretz ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Elderly Men ◽  
High Risk Prostate Cancer ◽  
Healthy Elderly ◽  
Specific Mortality ◽  
Risk Prostate Cancer ◽  
Cancer Specific Mortality

Development of a nomogram to predict for all-cause and cancer-specific mortality in high-risk prostate cancer treated by external beam radiotherapy and androgen deprivation.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e16004-e16004 ◽  
Author(s):  
Rahul D. Tendulkar ◽  
Michael W. Kattan ◽  
Changhong Yu ◽  
Chandana A. Reddy ◽  
Kevin L. Stephans ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Competing Risks ◽  
External Beam Radiotherapy ◽  
External Beam ◽  
Concordance Index ◽  
High Risk Prostate Cancer ◽  
Specific Mortality ◽  
Risk Prostate Cancer ◽  
Cancer Specific Mortality

e16004 Background: Men receiving high dose external beam radiotherapy (EBRT) and androgen deprivation therapy (ADT) for high risk prostate cancer (HRPC) have other competing causes of mortality, however predictive schema do not account for patient-related co-morbidities. We aim to create nomograms estimating all-cause mortality (ACM) and prostate cancer-specific mortality (PCSM) in this population. Methods: 660 patients with HRPC defined by NCCN guidelines were treated with EBRT ≥74 Gy and ADT from 1996-2009. The probabilities of death from prostate cancer and other causes were estimated by cumulative incidence function. Multivariable Cox proportional hazards regression and competing risks regression analyses were used for modeling ACM and PCSM respectively. Deaths from other causes were treated as competing risks for PCSM. Missing values in the predictors were multiply imputed before conducting multivariable regression analysis. Variables investigated were age, clinical T stage, prostate specific antigen (PSA), Gleason score, race, family history, duration of ADT, body mass index (BMI), Charlson co-morbidity index score, coronary artery disease, and smoking pack-years. The stepdown method was used to make parsimonious models based on the rank of the predictive ability of each variable with respect to each endpoint. The final nomograms were internally validated by assessing the discrimination and calibration with bootstrap resamples. Results: At last follow up, there were 199 deaths. The 10-year cumulative incidence of death from prostate cancer was 14% and from other causes was 26%. The variables that predicted for 10-year ACM included age, PSA, BMI, Charlson score, and smoking pack-years. The ACM nomogram achieved a concordance index of 0.672. The variables that predicted for PCSM included Gleason score, PSA, race, and duration of ADT. The nomogram concordance index for PCSM was 0.673. The calibrations for both ACM and PCSM appear reasonable. Conclusions: We have developed nomograms that predict for ACM and PCSM in men with aggressive prostate cancer and competing risks of death. External validation may be useful.

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