1836 RISK ASSESSMENT: PRE-DIAGNOSTIC PREDICTORS FOR PROSTATE CANCER MORTALITY AND DISTANT METASTASIS

219 Background: Adverse pathology (AP) at radical prostatectomy (RP) is often used as a proxy for long-term prostate cancer outcomes. The goal of this study was to assess the association of AP at RP, defined as high-grade (> Grade Group 3) and/or non-organ confined disease (pT3), with distant metastasis and prostate cancer death. Methods: A stratified cohort sample of 428 patients was used to evaluate the association of adverse pathology with the risk of distant metastases and prostate cancer-specific mortality over 20 years after prostatectomy in 2641 patients treated between 1987-2004. Cox regression of cause-specific hazards was used to estimate the absolute risk of both endpoints, with death from other causes treated as a competing risk. Subgroup analysis in patients with low/intermediate risk disease potentially eligible for active surveillance was performed. Results: Among the 428 patients, 343 had AUA Low or Intermediate risk disease and 85 had High risk disease. Median follow-up time was 15.5 years (IQR 14.6–16.6 years). Using the cohort sampling weights for estimation, at RP 29.8% of patients had high-grade disease, 42.3 % had non-organ confined disease, 19.3% had both, and thus 52.8% had AP. Adverse pathology was highly associated with metastasis and prostate cancer mortality in the overall cohort (HR 12.30, 95% CI 5.30-28.55, and 10.03, 95% CI 3.42-29.47, respectively, both p<0.001), and in the low/intermediate risk subgroup potentially eligible for active surveillance (HR 10.48, 95% CI 4.18-26.28, and 8.60, 95% CI 2.40-30.84, respectively, both p≤0.001). Conclusions: Adverse pathology at radical prostatectomy is highly associated with future development of metastasis and prostate cancer mortality and may be used as a short-term predictor of outcomes. [Table: see text]

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Validating the Association of Adverse Pathology with Distant Metastasis and Prostate Cancer Mortality 20-Years After Radical Prostatectomy

Urologic Oncology Seminars and Original Investigations ◽

10.1016/j.urolonc.2021.10.005 ◽

2021 ◽

Author(s):

Michael A. Brooks ◽

Lewis Thomas ◽

Cristina Magi-Galluzzi ◽

Jianbo Li ◽

Michael R. Crager ◽

...

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Distant Metastasis ◽

Cancer Mortality ◽

Prostate Cancer Mortality

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THE UCSF CANCER OF THE PROSTATE RISK ASSESSMENT (CAPRA) SCORE ACCURATELY PREDICTS METASTASIS, PROSTATE CANCER MORTALITY, AND ALL-CAUSE MORTALITY REGARDLESS OF TREATMENT TYPE

The Journal of Urology ◽

10.1016/s0022-5347(08)60329-8 ◽

2008 ◽

Vol 179 (4S) ◽

pp. 114-115 ◽

Cited By ~ 2

Author(s):

Matthew R Cooperberg ◽

Jeannette M Broering ◽

Peter R Carroll

Keyword(s):

Prostate Cancer ◽

Risk Assessment ◽

Cancer Mortality ◽

Prostate Cancer Mortality ◽

Treatment Type ◽

All Cause Mortality ◽

Cancer Of The Prostate

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Aspirin use in prostate cancer and the risk of death and metastasis.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.1518 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 1518-1518 ◽

Cited By ~ 1

Author(s):

Jonathan Assayag ◽

Laurent Azoulay ◽

Hui Yin ◽

Michael N. Pollak ◽

Samy Suissa

Keyword(s):

Prostate Cancer ◽

Cancer Diagnosis ◽

Distant Metastasis ◽

Cancer Mortality ◽

Control Analysis ◽

Cancer Outcomes ◽

Prostate Cancer Diagnosis ◽

Prostate Cancer Mortality ◽

All Cause Mortality

1518 Background: There has been recent interest in the role of aspirin in preventing prostate cancer outcomes, but data remain limited. The objective was to determine whether the use of aspirin after prostate cancer diagnosis is associated with a decreased risk of prostate cancer mortality, distant metastasis and all-cause mortality in men newly-diagnosed with prostate cancer. Methods: A population-based cohort of men diagnosed with non-metastatic prostate cancer between 01/04/1998 and 31/12/2009 was identified using the UK Clinical Practice Research Datalink, including the Cancer Registry. All men were followed until death, distant metastasis, or 01/10/2012. A nested case-control analysis was performed where, for each case with an incident outcome event, up to 10 controls were matched on age, year of diagnosis and duration of follow-up. Exposure was defined as aspirin use during the matched follow-up period. Rate ratios (RR) and 95% confidence intervals (CI) were estimated using conditional logistic regression, adjusted for covariates and considering effect modification by aspirin use prior to prostate cancer diagnosis. Results: The cohort included 13,396 prostate cancer patients, followed for 3.9 (SD=2.4) years during which 4,425 deaths occurred, including 2,315 from prostate cancer, and 2,344 cases of distant metastasis. Aspirin use was associated with an increased risk of prostate cancer mortality (RR 1.36, 95% CI 1.18-1.55) and all-cause mortality (RR 1.33, 95% CI 1.21-1.47), but not distant metastasis (RR 1.09, 95% CI 0.94-1.27). The increased risks were limited to patients who did not use aspirin before diagnosis, for both prostate cancer mortality (RR 1.69, 95% CI 1.43-2.00) and all-cause mortality (RR 1.62, 95% CI 1.44-1.82), while those who used aspirin before diagnosis did not have increased risks (RR 0.93, 95% CI 0.76-1.15 and RR 0.98, 95% CI 0.85-1.13, respectively). Conclusions: The use of aspirin after prostate cancer diagnosis is not associated with a decreased risk of prostate cancer outcomes. Although increased risks were observed for all-cause and prostate cancer mortality, these effects were exclusively driven by new-users of aspirin, suggesting that aspirin use in these patients was likely related to disease progression.

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