Identification of patients with prostate cancer who benefit from immediate postoperative radiotherapy: EORTC 22911
| Autor: | Van der Kwast TH, Bolla M, Van Poppel H, Van Cangh P, Vekemans K, Da Pozzo L, Bosset JF, Kurth KH, Schröder FH, Collette L, and EORTC 22911 |
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| Přispěvatelé: | Van der Kwast, T, Bolla, M, Van Poppel, H, Van Cangh, P, Vekemans, K, Da Pozzo, L, Bosset, J, Kurth, K, Schröder, F, Collette, L, and EORTC, 2, 06 Operations Centre and intensive care, Département de cancérologie et radiothérapie, CHU Grenoble, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Pathology, Urology |
| Rok vydání: | 2007 |
| Předmět: |
Oncology
Male Cancer Research MESH: Combined Modality Therapy medicine.medical_treatment 030232 urology & nephrology MESH : Aged law.invention [ SDV.CAN ] Life Sciences [q-bio]/Cancer MESH: Proportional Hazards Models Prostate cancer 0302 clinical medicine Randomized controlled trial law MESH: Risk Factors Risk Factors Medicine Stage (cooking) MESH : Prostate-Specific Antigen MESH: Treatment Outcome MESH: Aged MESH: Middle Aged Prostatectomy Hazard ratio Middle Aged MESH : Risk Factors Combined Modality Therapy 3. Good health MESH: Prostate-Specific Antigen Europe Treatment Outcome 030220 oncology & carcinogenesis Disease Progression MESH : Disease-Free Survival MESH: Disease Progression Positive Surgical Margin MESH : Prostatic Neoplasms medicine.medical_specialty MESH : Prostatectomy MESH : Male MESH : Europe [SDV.CAN]Life Sciences [q-bio]/Cancer MESH : Treatment Outcome Disease-Free Survival 03 medical and health sciences MESH: Prostatectomy SDG 3 - Good Health and Well-being Internal medicine Humans MESH : Middle Aged Aged Proportional Hazards Models MESH: Humans business.industry MESH : Humans Cancer Prostatic Neoplasms MESH : Disease Progression Prostate-Specific Antigen medicine.disease MESH : Proportional Hazards Models MESH: Male Surgery Radiation therapy MESH: Prostatic Neoplasms MESH: Disease-Free Survival MESH: Europe business MESH : Combined Modality Therapy adjuvant radiotherapy prostate cancer survival outcomes |
| Zdroj: | Journal of clinical oncology, 25(27), 4178-4186. American Society of Clinical Oncology Journal of Clinical Oncology Journal of Clinical Oncology, American Society of Clinical Oncology, 2007, 25 (27), pp.4178-4186. 〈10.1200/JCO.2006.10.4067〉 Journal of Clinical Oncology, American Society of Clinical Oncology, 2007, 25 (27), pp.4178-4186. ⟨10.1200/JCO.2006.10.4067⟩ Journal of Clinical Oncology, 25(27), 4178-4186. American Society of Clinical Oncology |
| ISSN: | 1527-7755 0732-183X |
| DOI: | 10.1200/JCO.2006.10.4067〉 |
| Popis: | Purpose The randomized controlled European Organisation for Research and Treatment of Cancer (EORTC) trial 22911 studied the effect of radiotherapy after prostatectomy in patients with adverse risk factors. Review pathology data of specimens from participants in this trial were analyzed to identify which factors predict increased benefit from adjuvant radiotherapy. Patients and Methods After prostatectomy, 1,005 patients with stage pT3 and/or positive surgical margins were randomly assigned to a wait-and-see (n = 503) and an adjuvant radiotherapy (60 Gy conventional irradiation) arm (n = 502). Pathologic review data were available for 552 patients from 11 participating centers. The interaction between the review pathology characteristics and treatment benefit was assessed by log-rank test for heterogeneity (P < .05). Results Margin status assessed by review pathology was the strongest predictor of prolonged biochemical disease-free survival with immediate postoperative radiotherapy (heterogeneity, P < .01): by year 5, immediate postoperative irradiation could prevent 291 events/1,000 patients with positive margins versus 88 events/1,000 patients with negative margins. The hazard ratio for immediate irradiation was 0.38 (95% CI, 0.26 to 0.54) and 0.88 (95% CI, 0.53 to 1.46) in the groups with positive and negative margins, respectively. We could not identify a significant impact of the positive margin localization. Conclusion Provided careful pathology of the prostatectomy is performed, our results suggest that immediate postoperative radiotherapy might not be recommended for prostate cancer patients with negative surgical margins. These findings require validation on an independent data set. |
| Databáze: | OpenAIRE |
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