Impact of Percent Positive Biopsy Cores on Cancer-Specific Mortality for Patients with High-Risk Prostate Cancer
| Autor: | Peter F. Orio, Martin T. King, Michelle D. Nezolosky, Shelby A. Labe, Toni K. Choueiri, Vinayak Muralidhar, Marie E. Vastola, Neil E. Martin, Paul L. Nguyen, Ninjin Boldbaatar, Quoc-Dien Trinh, Kent W. Mouw, Brandon A. Mahal, David D. Yang |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty Urology 030232 urology & nephrology Disease Risk Assessment Cohort Studies 03 medical and health sciences Prostate cancer 0302 clinical medicine Internal medicine Epidemiology Biopsy Surveillance Epidemiology and End Results medicine Humans Radiology Nuclear Medicine and imaging Clinical significance Stage (cooking) Cancer specific mortality Aged Radiation medicine.diagnostic_test business.industry Prostatic Neoplasms Middle Aged medicine.disease digestive system diseases Oncology 030220 oncology & carcinogenesis Biopsy Large-Core Needle business Percent Positive |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 102:e150 |
| ISSN: | 0360-3016 2010-2011 |
| Popis: | A high percent positive biopsy cores (PBC), typically dichotomized at ≥50% is prognostic of worse cancer-specific outcomes for patients with low- and intermediate-risk prostate cancer (CaP). The clinical significance of ≥50% PBC for patients with high-risk disease is poorly understood. We examined the association between ≥50% PBC, compared to50% PBC, and prostate cancer-specific mortality (PCSM) for patients with high-risk disease.We identified 7,569 men from the Surveillance, Epidemiology, and End Results program who were diagnosed with high-risk CaP (Gleason score of 8-10, prostate-specific antigen20 ng/mL, or cT3-T4 stage) in 2010-2011 and had 6 to 24 cores sampled at biopsy. Multivariable Fine and Gray competing risks regression was utilized to examine the association between ≥50% PBC and PCSM.Median follow-up was 3.8 years. 56.2% of patients (4,253) had ≥50% PBC. On competing risks regression, ≥50% PBC was associated with a significantly higher risk of PCSM compared to50% PBC (adjusted hazard ratio [AHR] 2.00, 95% confidence interval [CI] 1.48-2.70, P0.001). On subgroup analyses, ≥50% PBC was associated with a significantly higher risk of PCSM only for cT1-T2 disease (AHR 2.23, 95% CI 1.62-3.07) but not cT3-T4 disease (AHR 0.83, 95% CI 0.39-1.76), with a significant interaction (PIn this large cohort of patients with high-risk CaP, ≥50% PBC was independently associated with an approximately 2-fold increased risk of PCSM for patients with cT1-T2, but not cT3-T4, tumors. Percent PBC, which is a widely available clinical value, should be routinely used to risk stratify men with high-risk disease and identify patients whom may benefit from treatment intensification. |
| Databáze: | OpenAIRE |
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