PSA failure and the risk of death in prostate cancer patients treated with radiotherapy: In regard to Kwan et al. (Int J Radiat Oncol Biol Phys 2004;60:1040–1046)

IntroductionProstate cancer is a common malignancy in men that is difficult to treat and carries a high risk of death. miR-219-5p is expressed in reduced amounts in many malignancies. However, the prognostic value of miR-219-5p for patients with prostate cancer remains unclear.MethodsWe retrospectively analysed data from 213 prostate cancer patients from 10 June 2012 to 9 May 2015. Overall survival was assessed by Kaplan-Meier analysis and Cox regression models. Besides, a prediction model was constructed, and calibration curves evaluated the model’s accuracy.ResultsOf the 213 patients, a total of 72 (33.8%) died and the median survival time was 60.0 months. We found by multifactorial analysis that miR-219-5p deficiency increased the risk of death by nearly fourfold (HR: 3.86, 95% CI): 2.01 to 7.44, p<0.001) and the risk of progression by twofold (HR: 2.79, 95% CI: 1.68 to 4.64, p<0.001). To quantify each covariate’s weight on prognosis, we screened variables by cox model to construct a predictive model. The Nomogram showed excellent accuracy in estimating death’s risk, with a corrected C-index of 0.778.ConclusionsmiR-219-5p can be used as a biomarker to predict death risk in prostate cancer patients. The mortality risk prediction model constructed based on miR-219-5p has good consistency and validity in assessing patient prognosis.

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Prostate-specific antigen failure despite pathologically organ-confined and margin-negative prostate cancer: the basis for an adjuvant therapy trial.

Journal of Clinical Oncology ◽

10.1200/jco.1997.15.4.1465 ◽

1997 ◽

Vol 15 (4) ◽

pp. 1465-1469 ◽

Cited By ~ 39

Author(s):

A V D'Amico ◽

R Whittington ◽

S B Malkowicz ◽

D Schultz ◽

J E Tomaszewski ◽

...

Keyword(s):

Prostate Cancer ◽

Adjuvant Therapy ◽

Cancer Patients ◽

Prostate Specific Antigen ◽

Gleason Score ◽

Multivariable Analysis ◽

Specific Antigen ◽

Radical Retropubic Prostatectomy ◽

Phase Iii ◽

Psa Failure

PURPOSE A multivariable analysis to evaluate the potential clinical and pathologic factors that predict for early biochemical failure in patients with pathologically organ-confined and margin-negative disease was performed to define patients who may benefit from adjuvant therapy. PATIENTS AND METHODS Three hundred forty-one prostate cancer patients treated with a radical retropubic prostatectomy between January 1989 and June 1995 and found to have pathologically organ-confined and margin-negative disease comprised the study population. A logistic regression multivariable analysis to evaluate the predictive value of the preoperative prostate-specific antigen (PSA) level, pathologic (prostatectomy) Gleason score, and pathologic stage on PSA failure occurring during the first postoperative year was performed. RESULTS Predictors of PSA failure during the first postoperative year in patients with pathologically organ-confined disease included pathologic Gleason score > or = 7 (P = .0007) and preoperative PSA level greater than 10 (P < .0001). Corresponding 3-year freedom-from-PSA-failure rates for these pathologic organ-confined patients with both, one, or neither of these factors were 60%, 75% to 84%, and 95%, respectively (P < .0001). CONCLUSION Prostate cancer patients with pathologically organ-confined and margin-negative disease and a preoperative PSA level greater than 10 ng/mL or a pathologic Gleason score > or = 7 have significant decrements in short-term PSA-failure-free survival. Therefore, these patients should be considered for adjuvant therapy in the setting of a phase III clinical trial.

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Urinary dysfunction appears to be the primary determinant of castration versus observation for prostate cancer patients with PSA failure

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.14621 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 14621-14621

Author(s):

J. A. Zagory ◽

C. Chang ◽

S. Knight ◽

E. A. Lyons ◽

C. L. Bennett

Keyword(s):

Prostate Cancer ◽

Cancer Patients ◽

Watchful Waiting ◽

Specific Antigen ◽

Hormonal Treatment ◽

Initial Therapy ◽

Urinary Dysfunction ◽

Definitive Treatment ◽

Psa Failure ◽

Decision Satisfaction

14621 Background: After undergoing definitive treatment for a primary localized disease, prostate cancer patients may experience a rise in their prostate specific antigen (PSA) levels. Treating PSA failure with hormonal treatment has many health related quality of life (HRQOL) implications, including urinary, bowel, sexual, and male hormonal problems. Predictors of choice between hormonal treatment versus watchful waiting have not been investigated. Methods: Patients were approached after consecutive rises in PSA levels (n = 31). Patients completed HRQOL and decision satisfaction questionnaires, and a literacy assessment. Results: Patients were between 56 and 85 years old; 55% were African American. 71% of African Americans and 50% of whites had low functional literacy. 58% of patients chose hormonal therapy to treat their PSA rise; 81% of patients reported urinary problems. All patients reported decision satisfaction (see Table). Factors associated with castration versus watchful waiting were primarily related to poor urologic function, and were not specifically prostate cancer related (dysuria, nocturia, urination frequency). Conclusions: Primary treatment of urinary dysfunction, rather than castration, should be evaluated as initial therapy for prostate cancer patients with PSA failure. [Table: see text] No significant financial relationships to disclose.

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Quality of life and LhRH agonist therapy among prostate cancer patients who experience PSA failure

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.9093 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 9093-9093

Author(s):

K. F. Kline ◽

O. Sartor ◽

N. A. Dandade ◽

N. J. Nonzee ◽

B. D. Vicuna ◽

...

Keyword(s):

Quality Of Life ◽

Prostate Cancer ◽

Cancer Patients ◽

Lhrh Agonist ◽

Agonist Therapy ◽

Psa Failure ◽

Health Related Qol ◽

Health Related ◽

Lhrh Therapy

9093 Background: Growing numbers of prostate cancer patients survive for extended periods of time after initial diagnosis and treatment. Many experience a biochemical relapse (“PSA failure”) some time after prostatectomy or pelvic radiation. LhRH agonist therapy can reduce PSA levels, but its impact on survival time and quality of life (QOL) is unclear. We evaluated these concerns among Veterans who experienced PSA Failure. Methods: Eligibility criteria included: receipt of primary therapy for prostate cancer followed by a PSA nadir and subsequent PSA rise to at least 0.2 ng/ml. Data sources include patients (interviewer administered survey instruments on health-related QOL at baseline, 3 and 12 months) and medical records (clinical and laboratory findings). Results: 69 patients from the Jesse Brown VA Medical Center in Chicago have enrolled in the study to date. At their baseline interviews, 30 patients (43.5%) were receiving LhRH agonists (46.1% of 39 African-American patients and 48.0% of 25 White patients). LhRH agonist patients reported worse health-related QOL in domains relevant to prostate cancer than watchful waiting (WW) patients ( Table ), including increased frequency of urination, difficulty controlling urination, greater erectile dysfunction, and more limits on sexual activity. LhRH agonist and WW patients reported similar levels of sexual satisfaction. Conclusion: Of the PSA failure patients studied in this sample, those receiving LhRH agonist therapy experience more problems with urinary and sexual function than those who opted for WW. Longitudinal study will provide information about whether the LhRH therapy causes these side effects, or whether symptomatic patients are more likely to choose LhRH therapy than those with few prostate cancer symptoms. [Table: see text] No significant financial relationships to disclose.

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