Clinical Outcomes for Patients With Gleason Score 10 Prostate Adenocarcinoma: Results From a Multi-institutional Consortium Study.

Autor:	Sandler KA; Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, California., Cook RR; Department of Epidemiology, Fielding School of Public Health at UCLA, Los Angeles, California., Ciezki JP; Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio., Ross AE; Department of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland., Pomerantz MM; Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts., Nguyen PL; Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts., Shaikh T; Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania., Tran PT; Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland., Stock RG; Department of Radiation Oncology, The Icahn School of Medicine at Mount Sinai, New York, New York., Merrick GS; Schiffler Cancer Center, Wheeling Hospital, Wheeling Jesuit University, Wheeling, West Virginia., Demanes DJ; Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, California., Spratt DE; Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan., Abu-Isa EI; Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan., Wedde TB; Department of Oncology, Oslo University Hospital-Norwegian Radium Hospital, Norway., Lilleby W; Department of Oncology, Oslo University Hospital-Norwegian Radium Hospital, Norway., Krauss DJ; William Beaumont School of Medicine, Oakland University, Royal Oak, Michigan., Shaw GK; Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts., Alam R; Department of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland., Reddy CA; Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio., Song DY; Department of Radiation Oncology, The Icahn School of Medicine at Mount Sinai, New York, New York., Klein EA; Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio., Stephenson AJ; Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio., Tosoian JJ; Department of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland., Hegde JV; Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, California., Yoo SM; Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, California., Fiano R; Department of Radiation Oncology, The Icahn School of Medicine at Mount Sinai, New York, New York., D'Amico AV; Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts., Nickols NG; Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, California; Department of Radiation Oncology, Veteran Affairs Greater Los Angeles Healthcare System, Los Angeles, California., Aronson WJ; Department of Radiation Oncology, Veteran Affairs Greater Los Angeles Healthcare System, Los Angeles, California; Department of Urology, University of California, Los Angeles, Los Angeles, California., Sadeghi A; Department of Radiation Oncology, Veteran Affairs Greater Los Angeles Healthcare System, Los Angeles, California., Greco SC; Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland., Deville C; Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland., McNutt T; Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland., DeWeese TL; Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland., Reiter RE; Department of Urology, University of California, Los Angeles, Los Angeles, California., Said JW; Department of Pathology, University of California, Los Angeles, Los Angeles, California., Steinberg ML; Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, California., Horwitz EM; Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania., Kupelian PA; Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, California., King CR; Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, California., Kishan AU; Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, California. Electronic address: aukishan@mednet.ucla.edu.
Jazyk:	angličtina
Zdroj:	International journal of radiation oncology, biology, physics [Int J Radiat Oncol Biol Phys] 2018 Jul 15; Vol. 101 (4), pp. 883-888. Date of Electronic Publication: 2018 Apr 05.
DOI:	10.1016/j.ijrobp.2018.03.060
Abstrakt:	Purpose: Gleason score (GS) 10 disease is the most aggressive form of clinically localized prostate adenocarcinoma (PCa). The long-term clinical outcomes and overall prognosis of patients presenting with GS 10 PCa are largely unknown because of its rarity. Methods and Materials: The study included 112 patients with biopsy-determined GS 10 PCa who received treatment with radical prostatectomy (RP, n = 26), external beam radiation therapy (EBRT, n = 48), or EBRT with a brachytherapy boost (EBRT-BT, n = 38) between 2000 and 2013. Propensity scores were included as covariates for comparative analysis. Overall survival, prostate cancer-specific survival, and distant metastasis-free survival (DMFS) were estimated by the Kaplan-Meier method with inverse probability of treatment weighting to control for confounding. Results: The median follow-up period was 4.9 years overall (3.9 years for RP, 4.8 years for EBRT, and 5.7 years for EBRT-BT). Significantly more EBRT patients than EBRT-BT patients received upfront androgen deprivation therapy (98% vs 79%, P < .01 by χ 2 test), though the durations were similar (median, 24 months vs 22.5 months). Of the RP patients, 34% received postoperative EBRT, and 35% received neoadjuvant systemic therapy. The propensity score-adjusted 5-year overall survival rate was 80% for the RP group, 73% for the EBRT group, and 83% for the EBRT-BT group. The corresponding adjusted 5-year prostate cancer-specific survival rates were 87%, 75%, and 94%, respectively. The EBRT-BT group trended toward superior DMFS when compared with the RP group (hazard ratio, 0.3; 95% confidence interval 0.1-1.06; P = .06) and had superior DMFS when compared with the EBRT group (hazard ratio, 0.4; 95% confidence interval 0.1-0.99; P = .048). Conclusions: To our knowledge, this is the largest series ever reported on the clinical outcomes of patients with biopsy-determined GS 10 PCa. These data provide useful prognostic benchmark information for physicians and patients. Aggressive therapy with curative intent is warranted, as >50% of patients remain free of systemic disease 5 years after treatment. (Copyright © 2018 Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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