The need for more aggressive therapy for men with Gleason 9-10 disease compared to Gleason ≤8 high-risk prostate cancer
| Autor: | David A. Schwartz, Joseph P. Weiner, J. Safdieh, David Schreiber, E. Nwokedi |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Oncology
Male Cancer Research medicine.medical_specialty Antineoplastic Agents Hormonal medicine.medical_treatment External beam radiation 030232 urology & nephrology MEDLINE Disease Kaplan-Meier Estimate Disease-Free Survival Medical Records 03 medical and health sciences Prostate cancer 0302 clinical medicine Risk Factors Internal medicine Biomarkers Tumor Medicine Humans External beam radiotherapy Aged Retrospective Studies Aged 80 and over Neoplasm Grading business.industry Medical record Prostatic Neoplasms Retrospective cohort study Androgen Antagonists Radiotherapy Dosage General Medicine Luteinizing Hormone Middle Aged Prostate-Specific Antigen medicine.disease 030220 oncology & carcinogenesis business |
| Zdroj: | Tumori. 102(2) |
| ISSN: | 2038-2529 |
| Popis: | Purpose To evaluate the outcomes of prostate cancer patients with high-risk disease stratified by Gleason Score (GS) (GS ≤8 vs GS ≥9) treated with external beam radiotherapy (EBRT). Methods The medical records of patients who underwent EBRT between 2003 and 2011 and had nonmetastatic high-risk disease were analyzed retrospectively. Patients were treated with EBRT and all patients received a dose ≥7,560 cGy. Androgen deprivation therapy was given in most patients (90%). Results A total of 155 patients were identified (GS ≤8 n = 104, GS ≥9 n = 51), and they had a median presenting prostate-specific antigen (PSA) of 14.7 ng/mL. At a median follow-up of 69 months, the 7-year biochemical failure-free survival was 59.1% in those with GS ≥9 and 69.2% in those with GS ≤8 (p = 0.12). On MVA, Gleason 9-10 (HR 1.83, p = 0.08) was not associated with an increased risk of biochemical recurrence, while a PSA >20 ng/mL (HR 2.39, p = 0.04) was associated with an increased likelihood of biochemical recurrence. Patients with GS ≥9 were noted to have worse 7-year distant metastatic-free survival (79.6% vs 90.5% p = 0.02) and cancer-specific survival (88.5% vs 97.9%, p = 0.006). On MVA, GS ≥9 was a significant indicator of distant metastatic failure and cancer-related death. Seven-year overall survival rates remained similar between the groups. Conclusions In this high-risk cohort, patients with GS 9-10 had significantly worse prostate cancer-related outcomes than other high-risk patients, suggesting that this group may warrant more aggressive treatment modalities than their high-risk counterparts. |
| Databáze: | OpenAIRE |
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