Combining CAPRA-S with tumor IDC/C features improves the prognostication of biochemical recurrence in prostate cancer patients

Objective To evaluate the relationship between two year PSA nadir (PSAn) after brachytherapy and biochemical recurrence rates in prostate cancer patients. Materials and Methods In the period from January 1998 to August 2007, 120 patients were treated with iodine-125 brachytherapy alone. The results analysis was based on the definition of biochemical recurrence according to the Phoenix Consensus. Results Biochemical control was observed in 86 patients (71.7%), and biochemical recurrence, in 34 (28.3%). Mean PSAn was 0.53 ng/ml. The mean follow-up was 98 months. The patients were divided into two groups: group 1, with two year PSAn < 0.5 ng/ml after brachytherapy (74 patients; 61.7%), and group 2, with two year PSAn ≥ 0.5 ng/ml after brachytherapy (46 patients; 38.3%). Group 1 presented biochemical recurrence in 15 patients (20.3%), and group 2, in 19 patients (43.2%) (p < 0.02). The analysis of biochemical disease-free survival at seven years, stratified by the two groups, showed values of 80% and 64% (p < 0.02), respectively. Conclusion Levels of two year PSAn ≥ 0.5 ng/ml after brachytherapy are strongly correlated with a poor prognosis. This fact may help to identify patients at risk for disease recurrence.

Download Full-text

Oligometastatic Disease Detection with 68Ga-PSMA-11 PET/CT in Hormone-Sensitive Prostate Cancer Patients (HSPC) with Biochemical Recurrence after Radical Prostatectomy: Predictive Factors and Clinical Impact

Cancers ◽

10.3390/cancers13194982 ◽

2021 ◽

Vol 13 (19) ◽

pp. 4982

Author(s):

Carlos Artigas ◽

Romain Diamand ◽

Qaid Ahmed Shagera ◽

Nicolas Plouznikoff ◽

Fabrice Fokoue ◽

...

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Cancer Patients ◽

Predictive Factors ◽

Clinical Management ◽

Biochemical Recurrence ◽

Oligometastatic Disease ◽

Psma Pet ◽

Pet Ct ◽

Hormone Sensitive

Metastasis-directed therapy (MDT) in oligometastatic prostate cancer has the potential of delaying the start of androgen deprivation therapy (ADT) and disease progression. We aimed to analyze the efficacy of PSMA-PET/CT in detecting oligometastatic disease (OMD), to look for predictive factors of OMD, and to evaluate the impact of PSMA-PET/CT findings on clinical management. We retrospectively analyzed a homogeneous population of 196 hormone-sensitive prostate cancer patients (HSPC), considered potential candidates for MDT, with a PSMA-PET/CT performed at biochemical recurrence (BCR) after radical prostatectomy (RP). Multivariable logistic regression analysis was performed based on several clinico-pathological factors. Changes in clinical management before and after PSMA-PET/CT were analyzed. The OMD detection rate was 44% for a total positivity rate of 60%. PSMA-PET/CT positivity was independently related to PSA (OR (95%CI), p) (1.7 (1.3–2.3), p < 0.0001) and PSAdt (0.4 (0.2–0.8), p = 0.013), and OMD detection was independently related to PSA (1.6 (1.2–2.2), p = 0.001) and no previous salvage therapy (0.3 (0.1–0.9), p = 0.038). A treatment change was observed in 58% of patients, mostly to perform MDT after OMD detection (60% of changes). This study showed that PSMA-PET/CT is an excellent imaging technique to detect OMD early in HSPC patients with BCR after RP, changing therapeutic management mostly into MDT.

Download Full-text

High Occurrence of Aberrant Lymph Node Spread on Magnetic Resonance Lymphography in Prostate Cancer Patients With a Biochemical Recurrence After Radical Prostatectomy

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2011.04.054 ◽

2012 ◽

Vol 82 (4) ◽

pp. 1405-1410 ◽

Cited By ~ 25

Author(s):

Hanneke J.M. Meijer ◽

Emile N. van Lin ◽

Oscar A. Debats ◽

J. Alfred Witjes ◽

Paul N. Span ◽

...

Keyword(s):

Prostate Cancer ◽

Lymph Node ◽

Magnetic Resonance ◽

Radical Prostatectomy ◽

Cancer Patients ◽

Biochemical Recurrence ◽

High Occurrence

Download Full-text

Treatment changes in prostate cancer patients on active treatment during the COVID-19 pandemic in a community cancer center in New York City.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e18750 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e18750-e18750

Author(s):

Rose Snyder ◽

Trishala Meghal ◽

Andrew Wood ◽

Ariel Schulman ◽

Kevin Douglas Becker ◽

...

Keyword(s):

Prostate Cancer ◽

Cancer Patients ◽

Nurse Practitioners ◽

Biochemical Recurrence ◽

Health Concern ◽

Cancer Center ◽

Treatment Change ◽

Post Surgery ◽

Treatment Changes ◽

Schedule Change

e18750 Background: The surge of the SARS coronavirus-2 (COVID-19) pandemic posed great challenges in the oncology community for optimal management of cancer patients. We sought to analyze the treatment changes experienced by the prostate cancer patients in March, April and May 2020 and to compare these treatment decisions to the published guidelines. Methods: We focused on patients currently receiving androgen deprivation therapy (ADT) with leuprolide acetate, and/or oral anti-androgen agents (Androgen receptor axis targeted agent, ARAT), or chemotherapy. Electronic medical records were reviewed, and the oncologists and nurse practitioners were interviewed to understand the decision-making process. Results: Seventy-five patients were included, median age 72 years old (range 47-95). All were taking ADT, and 21 were also taking ARAT, and 3 were also receiving chemotherapy. The incidence and indications for their ADT treatments and schedule changes are shown in the table below. Twenty-seven patients (36%) experienced delays in their ADT treatment, and the percentage of treatment change was similar in categories of metastatic hormone sensitive prostate cancer (mHSPC), metastatic castration resistant cancer (mCRPC), biochemical recurrence as well as stage IVA post surgery. Four patients were receiving neoadjuvant ADT planned prior to definitive radiation, and none had schedule change. One patient with mHSPC and 2 patients with mCRPC continued chemotherapy as planned. One patient declined recommended chemotherapy for mCRPC. Two patients were given q 3 months dose of ADT instead of q 1m, while all the rest were already receiving q3 months dosing. Among the 27 patients who had schedule change, 12 (44.4%) patients had a discussion with their providers first, and 15 patients (55.6%) did not keep their treatment appointment. Conclusions: About one third of patients changed ADT injection schedule with a similar percentage in patients with mHSPC, or mCRPC or Biochemical recurrence, or IVA after surgery. Every 3 months dosing of ADT recommended by NCCN significantly decreases exposure to COVID -19, delaying or skipping treatment was still encountered due to health concern or travel limitations. On the other hand, all patients receiving neoadjuvant ADT, or chemotherapy stayed on schedule. Although NCCN guideline recommended delaying myelosuppressive therapy, palliative chemotherapy for symptomatic, refractory patients may still be a priority.[Table: see text]

Download Full-text

Cost-effectiveness of 68Ga-PSMA-11 PET/CT in Prostate Cancer Patients with Biochemical Recurrence

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2020.07.888 ◽

2020 ◽

Vol 108 (3) ◽

pp. S144-S145

Author(s):

N.R. Parikh ◽

D. Johnson ◽

A. Raldow ◽

M.L. Steinberg ◽

J. Czernin ◽

...

Keyword(s):

Prostate Cancer ◽

Cost Effectiveness ◽

Cancer Patients ◽

Biochemical Recurrence ◽

Pet Ct

Download Full-text

68Ga‐PSMA‐11 PET‐CT study in prostate cancer patients with biochemical recurrence and non‐contributive 18F‐Choline PET‐CT: Impact on therapeutic decision‐making and biomarker changes

The Prostate ◽

10.1002/pros.23751 ◽

2018 ◽

Vol 79 (5) ◽

pp. 454-461 ◽

Cited By ~ 7

Author(s):

Matthieu Barbaud ◽

Mathieu Frindel ◽

Ludovic Ferrer ◽

Maelle Le Thiec ◽

Daniela Rusu ◽

...

Keyword(s):

Prostate Cancer ◽

Decision Making ◽

Cancer Patients ◽

Biochemical Recurrence ◽

Therapeutic Decision ◽

Choline Pet ◽

Pet Ct ◽

Therapeutic Decision Making

Download Full-text

Usefulness of 18F-fluorocoline PET/CT in prostate cancer patients with biochemical recurrence: Influence of PSA kinetics and hormone therapy

Medicina Clínica (English Edition) ◽

10.1016/j.medcle.2019.05.001 ◽

2019 ◽

Vol 153 (2) ◽

pp. 56-62

Author(s):

Eva María Triviño-Ibáñez ◽

Ignacio Puche-Sanz ◽

Manuel Gómez-Río ◽

José Manuel Cózar Olmo ◽

José Manuel Llamas-Elvira ◽

...

Keyword(s):

Prostate Cancer ◽

Hormone Therapy ◽

Cancer Patients ◽

Biochemical Recurrence ◽

Psa Kinetics ◽

Pet Ct

Download Full-text

Does Gleason score of positive surgical margin after radical prostatectomy affect biochemical recurrence and oncological outcomes? Protocol for systematic review

BMJ Open ◽

10.1136/bmjopen-2019-034612 ◽

2020 ◽

Vol 10 (3) ◽

pp. e034612

Author(s):

Athul John ◽

Michael O'Callaghan ◽

Rick Catterwell ◽

Luke A Selth

Keyword(s):

Prostate Cancer ◽

Systematic Review ◽

Radical Prostatectomy ◽

Cancer Patients ◽

Gleason Score ◽

Biochemical Recurrence ◽

Surgical Margins ◽

Secondary Treatment ◽

Oncological Outcomes

IntroductionPositive surgical margins (PSM) in cancer patients are commonly associated with worse prognosis and a higher risk of secondary treatment. However, the relevance of this parameter in prostate cancer patients undergoing radical prostatectomy (RP) remains controversial, given the inconsistencies in its ability to predict biochemical recurrence (BCR) and oncological outcomes. Hence, further assessment of the utility of surgical margins for prostate cancer prognosis is required to predict these outcomes more accurately. Over the last decade, studies have used the Gleason score (GS) of positive margins to predict outcomes. Herein, the authors aim to conduct a systematic review investigating the role of GS of PSM after radical prostatectomy in predicting BCR and oncological outcomes.Methods and analysisWe will perform a search using MEDLINE, EMBASE, SCOPUS and COCHRANE databases. The review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We will screen titles and abstracts to select articles appropriate for full-text review. Studies discussing GS of PSM after RP will be included. Given the change in reporting of GS, only articles from 2005 to 2019 will be included. The quality of the studies chosen will be assessed using the Newcastle Ottawa tool for non-randomised and Cochrane risk of bias for randomised control studies. We will adopt the grading of recommendations, assessment, development and evaluation framework to comment on quality of cumulative evidence. The primary outcome measure will be time to BCR. Secondary outcome measures include secondary treatment, disease-specific survival, disease progression-free and overall mortality at follow-up period. We aim to perform a meta-analysis if the level of heterogeneity is acceptable (I2<50%).Ethics and disseminationThe review does not require ethics approval as it is a review of published literature. The findings of the review will be submitted for peer-reviewed publications and presented at scientific meetings.PROSPERO registration numberCRD42019131800.

Download Full-text