PD10-02 TIME TO BIOCHEMICAL RECURRENCE (BCR) IN PATIENTS WITH LOCALIZED HIGH-RISK PROSTATE CANCER (PC) TREATED WITH NEOADJUVANT ANDROGEN BLOCKADE (NAB) PRIOR TO RADICAL PROSTATECTOMY (RP): RESULTS OF A POOLED ANALYSIS OF THREE PHASE 2 TRIALS

e16535 Background: Development of biochemical recurrence with a rising PSA level after radical prostatectomy causes significant anxiety for patients and treating oncologist. Management of these patients is controversial. Here, we characterize the natural course and pattern of disease progression and survival in men with biochemical recurrence (BCR) after radical prostatectomy (RP) for intermediate and high-risk prostate cancer (PCa) untreated until clinical failure (CF). Methods: Retrospective analysis of consecutive men with BCR after RP for intermediate/high risk PCa. All patients underwent RP+extended pelvic lymph node dissection. A PSA level > 0.2 ng/ml on two consecutive measures was considered BCR. None received neoadjuvant or adjuvant therapy prior to documented clinical failure by body imaging, which was performed at the time point of BCR or symptoms and at least once per year. Results: Of the 622 men with BCR included into the analysis, 267 (43%) had high risk PCa. Median follow-up after RP was 9.4 yrs. (IQR 4.8-15.1) and median time from RP to BCR was 1.4 yrs. (IQR 0.4-3.6). Of the patients 324 (52%) never experienced CF (Æfollow-up from BCR 5.8yr, IQR2.1-11.9); 88 (14%) had local recurrence only; 59 (9%) had lymph node metastasis +/-local recurrence and 151(24%) distant metastasis. The median times from BCR to CF were: 9.5 yrs. (IQR 5.6-13.5) for local failure; 4.9 yrs. (IQR 3.1-8.8) for lymph node failure and 5.6 yrs. (IQR 3-10.5) for distant failure. The 10-yrs cancer specific (CSS) and overall survival (OS) of the entire group from time point of BCR was 78% and 66%, respectively. 5- and 7-yrs conditional CSS from time of CF was strongly depended on recurrence pattern and ranged from 90% and 79% (local only) to 70% and 47% (lymph node+/-local) and 47% and 36% (distant mets), respectively. PSA-doubling time < 12 months and > 2 positive nodes were independent predictors of outcome in multivariate analysis. Conclusions: These data may be useful in informing men with intermediate/high risk PCa regarding the natural course of PSA recurrence and counseling the timing of additional therapies.

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659 PHASE 2 TRIAL OF NEOADJUVANT LHRH PLUS ESTRAMUSTINE FOR HIGH RISK PROSTATE CANCER FOLLOWED BY RADICAL PROSTATECTOMY

The Journal of Urology ◽

10.1016/j.juro.2010.02.1046 ◽

2010 ◽

Vol 183 (4S) ◽

Cited By ~ 1

Author(s):

Takuya Koie ◽

Teppei Okamoto ◽

Kengo Imanishi ◽

Naoki Sugiyama ◽

Yuichiro Suzuki ◽

...

Keyword(s):

Prostate Cancer ◽

High Risk ◽

Radical Prostatectomy ◽

Phase 2 ◽

High Risk Prostate Cancer ◽

Phase 2 Trial ◽

Risk Prostate Cancer

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Image-guided, whole-pelvic, intensity-modulated radiotherapy for biochemical recurrence following radical prostatectomy in high-risk prostate cancer patients

PLoS ONE ◽

10.1371/journal.pone.0190479 ◽

2018 ◽

Vol 13 (1) ◽

pp. e0190479 ◽

Cited By ~ 5

Author(s):

Sang Jun Byun ◽

Young Seok Kim ◽

Hanjong Ahn ◽

Choung-Soo Kim

Keyword(s):

Prostate Cancer ◽

High Risk ◽

Radical Prostatectomy ◽

Cancer Patients ◽

Biochemical Recurrence ◽

Intensity Modulated Radiotherapy ◽

Image Guided ◽

Intensity Modulated ◽

High Risk Prostate Cancer ◽

Risk Prostate Cancer

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The impact of multifocal perineural invasion on biochemical recurrence and timing of adjuvant androgen-deprivation therapy in high-risk prostate cancer following radical prostatectomy.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.6_suppl.e595 ◽

2017 ◽

Vol 35 (6_suppl) ◽

pp. e595-e595

Author(s):

Pengfei Shen ◽

Guangxi Sun ◽

Hao Zeng ◽

Xingming Zhang

Keyword(s):

Prostate Cancer ◽

High Risk ◽

Radical Prostatectomy ◽

Androgen Deprivation Therapy ◽

Biochemical Recurrence ◽

Perineural Invasion ◽

Androgen Deprivation ◽

High Risk Prostate Cancer ◽

Risk Prostate Cancer ◽

The Impact

e595 Background: Perineural invasion (PNI) is a distinct pathologic entity and a recognized source of tumor spread. However, the role of PNI in high-risk prostate cancer (PCa) has not been explored. We investigated the impact of the severity of PNI on biochemical recurrence (BCR) and optimal timing of adjuvant androgen deprivation therapy (ADT) post radical prostatectomy (RP). Methods: Of 265 prostatectomies, median follow-up 45 months, were assessed for the presence of PNI and its intensity (unifocal PNI and multifocal PNI) in RP specimen. Kaplan-Merier curves were used to estimate BCR probabilities. Cox proportional hazard models were used to address predictors of BCR. Harrell’s C-index was conducted to further validate prognostic value of multi-PNI. Results: A total of 123 patients (46.4%) were PNI positive, among which, 91 (74%) and 32 (26%) had unifocal PNI (uni-PNI) and multifocal PNI (multi-PNI), respectively. Other than uni-PNI, the presence of multi-PNI was strongly associated with increasing incidence of BCR (HR = 3.87, 95% CI: 1.66-9.01, p = 0.002). Patients with uni-PNI seemed to have a similar BCR rate to those without PNI after adjuvant ADT. For men with multi-PNI, immediate ADT obviously appeared to be superior to delayed ADT in decreasing biochemical failure. Conclusions: Multi-PNI detected in high-risk RP specimens could be a prognosticator for early biochemical relapse post-surgery. Our findings suggest that patients with multi-PNI appear appropriate to choose adjuvant therapy as soon as possible after surgery.

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