scholarly journals High Lipoprotein(a) Level Is Independently Associated with Adverse Clinicopathological Features in Patients with Prostate Cancer

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Fang-Ming Wang ◽  
Yan Zhang
Keyword(s):  
Prostate Cancer ◽  
Logistic Regression ◽  
High Risk ◽  
Risk Group ◽  
Density Lipoprotein ◽  
Clinicopathological Features ◽  
The Other ◽  
Intermediate Risk ◽  
Regression Analyses ◽  
Lipid Parameters

Background. The effect of lipoprotein(a) (Lp(a)) on prostate cancer (PCa) is unclear. The aim of this study was to investigate the association between serum Lp(a) levels and clinicopathological features in patients with PCa. Methods. A total of 376 consecutive pathologically diagnosed PCa patients were enrolled and were classified as a low-intermediate-risk group or a high-risk group. The association of Lp(a) and the other lipid parameters including total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), TC/HDL-C, LDL-C/HDL-C, and remnant cholesterol (RC) with clinicopathological parameters was tested by univariate and multivariate logistic regression analyses. Results. The high-risk PCa patients tended to have higher Lp(a) levels (p=0.022) while there was no significant difference regarding the other lipid parameters (p>0.05) compared to low-intermediate-risk counterparts. Patients with PSA≥100 ng/ml had significantly higher Lp(a) levels than subjects with PSA<100 ng/ml (p=0.002). Univariate logistic regression analyses revealed that high Lp(a) levels were correlated with high-risk PCa (Q4 vs. Q1, HR=2.687, 95% CI: 1.113-6.491, p=0.028), while the other lipid parameters were not correlated with high-risk PCa. In the stepwise multivariate regression analysis, the association between Lp(a) levels and high-risk PCa remained significant (Q4 vs. Q1,HR=2.890, 95% CI: 1.148-7.274, p=0.024) after adjusting for confounding factors including age, body mass index, hypertension, diabetes, coronary artery disease, and lipid-lowering drugs. Conclusions. This is the first study showing the positive association between high Lp(a) and adverse clinicopathological features of PCa. PCa patients with high Lp(a) tends to be more aggressive and should receive more attention in clinical practice.

scholarly journals Comparison of Oncological Outcomes Between Radical Prostatectomy and Radiotherapy by Type of Radiotherapy in Elderly Prostate Cancer Patients

2021 ◽  
Vol 11 ◽  
Author(s):  
Xiao-Xiao Guo ◽  
Hao-Ran Xia ◽  
Hui-Min Hou ◽  
Ming Liu ◽  
Jian-Ye Wang
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Radical Prostatectomy ◽  
External Beam Radiotherapy ◽  
The Other ◽  
Oncologic Outcomes ◽  
Intermediate Risk ◽  
High Risk Patients ◽  
Significant Difference ◽  
Risk Patients

ObjectiveWe aimed compare the oncologic outcomes of radical prostatectomy (RP) with those of external beam radiotherapy (EBRT), brachytherapy (BT), or EBRT + BT (EBBT) in elderly patients with localised prostate cancer (PCa).MethodsLocalised PCa patients aged ≥70 years who underwent RP, EBRT, BT, or EBBT between 2004 and 2016 were identified from the Surveillance, Epidemiology, and End Results database. Multivariable competing risks survival analyses were used to estimate prostate cancer-specific mortality (CSM) and other-cause mortality (OCM). Subgroup analyses according to risk categories were also conducted.ResultsOverall, 14057, 37712, 8383, and 5244 patients aged ≥70 years and treated with RP, EBRT, BT, and EBBT, respectively, were identified. In low- to intermediate-risk patients, there was no significant difference in CSM risk between RP and the other three radiotherapy modalities (all P &gt; 0.05). The corresponding 10-year CSM rates for these patients were 1.2%, 2.3%, 2.0%, and 1.8%, respectively. In high-risk patients, EBRT was associated with a higher CSM than RP (P = 0.003), whereas there was no significant difference between RP and BT or RP and EBBT (all P &gt; 0.05). The 10-year CSM rates of high-risk patients in the RP, EBRT, BT, and EBBT groups were 7.5%, 10.2%, 8.3%, and 7.6%, respectively. Regarding OCM, the risk was generally lower in RP than in the other three radiotherapy modalities (all P &lt; 0.001).ConclusionsAmong men aged ≥70 years with localised PCa, EBRT, BT, and EBBT offer cancer-specific outcomes similar to those of RP for individuals with low- to intermediate-risk disease. In patients with high-risk disease, EBBT had outcomes equally favourable to those of RP, but RP is more beneficial than EBRT. More high-quality trials are warranted to confirm and expand the present findings.

High-dose-rate brachytherapy boost in prostate cancer: a New Zealand case series

2015 ◽  
Vol 15 (1) ◽  
pp. 23-29
Author(s):  
John K. L. Chin ◽  
Kenanao D. Rantshilane ◽  
Paul K. L. Chin ◽  
Anupam Chaudhuri ◽  
Leanne K. Tyrie ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Dose Rate ◽  
Risk Group ◽  
Late Toxicity ◽  
High Dose Rate ◽  
High Dose ◽  
Intermediate Risk ◽  
High Dose Rate Brachytherapy ◽  
Grade 3

AbstractAimThe aim of the present study was to report the survival outcomes and late toxicity of high-dose-rate brachytherapy (HDRBT) boost for dose escalation in patients with intermediate-to-high-risk prostate cancer.Materials and methodsRetrospective data were collected from 137 patients who had undergone definitive radiotherapy for prostate cancer between 2006 and 2010. All patients had external-beam radiotherapy (median dose 46Gy) and HDRBT. Brachytherapy dose was 19Gy in two fractions (6 hours apart) with one implant using Ir-192.ResultsThere were 94 high-risk and 43 intermediate-risk patients (NCCN classification). The median follow-up period was 60 months. The 5-year biochemical progression-free survival was 92 and 76% for intermediate- and high-risk groups, respectively. Prostate cancer-specific survival for the intermediate-risk group was 100% and for the high-risk group it was 92% at 5 years. For the entire cohort, the 5-year rate of urethral stricture formation was 13%, and the 5-year rate of late grade 2 and grade 3 gastrointestinal toxicity was 4·7 and 4·6%, respectively. There was no grade 3 or greater genitourinary toxicity.FindingsOur data add to the growing body of literature supporting the use of HDRBT in prostate cancer. Late toxicity rates were marginally higher than that expected.

Postrandomization analysis assessing survival following radiation therapy (RT) with or without 6 months of androgen suppression therapy (AST) for localized prostate cancer (PCa)

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 5129-5129
Author(s):  
P. L. Nguyen ◽  
M. H. Chen ◽  
C. J. Beard ◽  
M. Loffredo ◽  
A. A. Renshaw ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prognostic Factors ◽  
High Risk ◽  
Risk Group ◽  
Multivariable Analysis ◽  
Intermediate Risk ◽  
Risk Of Death ◽  
Increased Risk ◽  
High Risk Disease ◽  
Severe Comorbidity

5129 Background: 6 months of AST+RT was shown to improve survival vs. RT alone in men with unfavorable-risk localized PCa, but it is unknown if this benefit applied to all risk subgroups. Methods: Among 206 men with clinical T1b-T2b PCa and at least 1 unfavorable feature (PSA>10 or Gleason >=7 or MRI evidence of T3 disease) randomized to 70Gy of RT with or without 6 months of AST, we performed post-randomization subgroup analyses within four subgroups defined by both risk group (high risk [Gleason 8–10 or PSA >20] or intermediate risk [all others]), and by ACE-27 comorbidity level (no/limited comorbidity or moderate/severe comorbidity). Within the 4 subgroups a log-rank test was used to compare Kaplan Meier estimates of survival (requiring p < 0.05/4 or p < 0.0125 to adjust for multiple comparisons) and within the 2 risk groups we used Cox multivariable analysis (MVA) to assess the association of treatment with the risk of death after adjusting for known prognostic factors. Results: After a median follow-up 8.2 yrs, 74 men died. In men with no or minimal comorbidity, estimates of survival were significantly higher among those who received AST+RT vs. RT alone, regardless of whether they had intermediate risk disease (90.9 vs. 85.8% at 7yrs, p = 0.009) or high-risk disease (88.9% vs. 51.2% at 7yrs, p = 0.007). In men with moderate or severe comorbidity, no difference in survival was observed after AST+RT vs. RT in intermediate risk (p = 0.2) or high risk (p = 0.5). After adjusting for known prognostic factors, treatment with RT as compared to AST+RT was associated with an increased risk of death in men with intermediate (AHR: 3.0 [95% CI: 1.3 to 7.2]; p = 0.01) and high risk disease (AHR: 3.3 [95% CI: 0.94 to 11.3]; p = 0.06) in a model that adjusted for the interaction between treatment and comorbidity. Conclusions: Among men with T1b-T2b prostate cancer who have no or minimal comorbidity, the addition of 6 months of AST to RT was associated with improved survival in men with both intermediate risk and high-risk disease. Among men with moderate to severe comorbidity, neither risk group appeared to benefit from the addition of AST. No significant financial relationships to disclose.

Prostate cancer–specific mortality after definitive radiation therapy: Who dies of disease?

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 181-181
Author(s):  
M. M. Kim ◽  
K. E. Hoffman ◽  
L. B. Levy ◽  
S. J. Frank ◽  
S. Choi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
High Risk ◽  
Risk Group ◽  
Low Risk ◽  
Intermediate Risk ◽  
High Risk Disease ◽  
Specific Mortality ◽  
Risk Patients ◽  
Cancer Specific Mortality

181 Background: A competing risks analysis was undertaken to identify patient subgroups at greatest risk of dying from prostate cancer (CAP) after treatment with definitive external beam radiation therapy (RT) +/− androgen deprivation therapy (ADT) in the PSA era, and to determine which factors predict for survival from disease. Methods: A total of 2,675 men with localized CAP treated with RT +/− ADT at M. D. Anderson Cancer Center from 1987-2007 were evaluated. Prostate cancer-specific mortality (PCSM) and other cause mortality rates were calculated after stratifying patients according to NCCN risk group, RT dose, use of ADT, and age at treatment. In total, 21% had low-risk, 40% had intermediate-risk, and 39% had high-risk disease. Multivariate analysis (MVA) was performed using Cox regression modeling. Results: Median age was 68.5 years and median follow-up was 6.4 years. For patients with low-risk disease, only 0.2% died of CAP 10 years after treatment. None of the low-risk patients <70 years old who received ≥72 Gy died of CAP. The majority of deaths in the intermediate-risk group were also due to other causes; men ≥70 years old who received <72 Gy had the highest 10-year PCSM (5%). High-risk patients <70 years old who received <72 Gy without ADT had similar 10-year rates of CAP (15.2%) and non-CAP (18.5%) mortality. Men with high-risk disease <70 years old treated with higher doses >72 Gy were twice as likely to die from non-CAP causes (15.9%) than die from CAP (8.6%). In older men ≥70 years old with high risk disease, dose-escalation with ADT reduced 10-year PCSM from 14% to 4%, and most deaths were due to other causes (41% and 20%). On MVA, dose (p=0.002), ADT (p=0.007), PSA (p<0.0001) and Gleason score (p<0.0001) were predictive of PCSM in the high-risk group. Conclusions: Men with low- and intermediate-risk CAP treated with definitive RT are unlikely to die of disease. PCSM is higher in men with high-risk disease but can be reduced with dose escalation and ADT, although patients are still twice as likely to die of other causes. No significant financial relationships to disclose.

An impact of pelvic MRI (PMRI) to radiotherapy (RT) target volumes definition in prostate cancer patients (pts).

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 78-78
Author(s):  
Keren Rouvinov ◽  
Wilmosh Mermershtain ◽  
Olga Beloshicki ◽  
Shmuel Ariad ◽  
Konstantin Lavrenkov
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Risk Group ◽  
High Risk Group ◽  
Evaluation Procedure ◽  
High Dose ◽  
Intermediate Risk ◽  
Group Affiliation ◽  
High Risk Prostate Cancer ◽  
Risk Prostate Cancer

78 Background: PMRI is a standard pre-RT evaluation procedure in pts with intermediate and high-risk prostate cancer. We conducted a retrospective study to evaluate an influence of PMRI to delineation of RT clinical target volume (CTV). Methods: Medical records of prostate cancer pts treated with intensity-modulated RT (IMRT) in single institution retrieved and examined retrospectively. Initial risk group affiliation was defined using D'Amico method. PMRI reports of pts with intermediate and high-risk prostate cancer were reviewed and risk group affiliation was re-defined in regards of T- and N-stage. IMRT treatment plans were re-assessed. In regards to PMRI T-stage, extra-capsular extension (ECE) and seminal vesicles invasion (SVI) were included to high-dose CTV. Pelvic lymph nodes (PLN) were planned to treat in all high-risk pts. PLN considered pathological by PMRI were included to separate CTV to receive RT dose higher than unaffected PLN stations. Results: Between 2008 and 2014, 169 pts with intermediate and high-risk prostate cancer underwent PMRI at around 1 month before commencing IMRT. Initially, 89 pts were affiliated to intermediate-risk and 80 to high-risk group. In general, PTV-changes based on PMRI data required in 77 pts (45.5%). Thirty seven of 89 intermediate-risk pts (41.6%) have been switched to high-risk group, necessitating irradiation of PLN. ECE and SVI were included to high-dose CTV in 64 (37.8%) and 29 pts (17.2%) respectively. PLN were thought pathological in 10 pts (5.9%), which demanded contouring of a separate CTV. Conclusions: In our series PMRI-scans had a significant impact on RT target coverage decision in pts with intermediate and high-risk prostate cancer.

Comparative effectiveness of intensity-modulated radiation therapy versus three-dimensional conformal radiation for localized prostate cancer.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 89-89
Author(s):  
Talha Shaikh ◽  
Karen Ruth ◽  
Nicholas George Zaorsky ◽  
Mark Hallman ◽  
Daniel M. Geynisman ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
High Risk ◽  
Risk Group ◽  
Three Dimensional ◽  
Intensity Modulated Radiation Therapy ◽  
Intermediate Risk ◽  
Intensity Modulated ◽  
Grade 3 ◽  
3D Crt

89 Background: Intensity-modulated radiation therapy (IMRT) has become the standard radiation delivery option for patients (pts) with localized (PCa) prostate cancer despite limited prospective data and increased cost relative to three-dimensional conformal radiation therapy (3D-CRT). The purpose of this study was to compare the treatment outcomes and toxicities of pts undergoing definitive dose-escalated radiation therapy using either 3D-CRT or IMRT for localized PCa. Methods: We identified men with clinically localized PCa treated with definitive external beam radiation at a single institution using >74 Gy between 1997-2013. Within each NCCN risk group, propensity score matching of 3D-CRT pts with one or two IMRT pts was performed accounting for age, race, diabetes, hypertension, Gleason score, T-stage, PSA, and hormone use. Conditional logistic and conditional Cox proportional hazards models were used to adjust for matched groups, with dose included as a separate covariate. Results: After matching,1,253 men (474 3D-CRT, 779 IMRT) were included. There were no significant differences between the IMRT and 3D-CRT pts according to clinical or treatment factors. There was no difference in biochemical failure (BCF), distant metastasis (DM), cancer specific survival (CSS), or overall survival (OS) amongst the low or intermediate risk subgroups. When examining the high-risk subgroup, pts receiving IMRT had higher rates of DM (HR 2.21 95% CI 1.04-4.74 p=0.040). There was a trend towards increased rates of BCF in pts receiving IMRT for high-risk disease (HR 1.60 95% CI 0.96-2.66 p=0.072). There was no difference in CSS or OS in the high-risk subset. In the intermediate risk group, patients receiving IMRT had increased rates of acute grade 3+ genitourinary toxicity versus 3D-CRT patients (OR 8.30 95% CI 2.13-2.15 p=0.002). There were otherwise no differences in acute or late grade 3+ genitourinary or gastrointestinal toxicity amongst IMRT versus 3D-CRT pts. Conclusions: Despite the widespread adoption of IMRT for localized PCa, our results do not demonstrate an improvement in outcomes or toxicity versus 3D-CRT. Further research is warranted to explain these findings.

scholarly journals Differentially methylated CpG sites associated with the high-risk group of prostate cancer

2020 ◽  
Vol 17 (4) ◽  
Author(s):  
Anastasiya Kobelyatskaya ◽  
Elena Pudova ◽  
Maria Fedorova ◽  
Kirill Nyushko ◽  
Boris Alekseev ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Dna Methylation ◽  
High Risk ◽  
Risk Group ◽  
Mrna Level ◽  
High Risk Group ◽  
Response To Therapy ◽  
The Cancer Genome Atlas ◽  
Intermediate Risk ◽  
Cpg Sites

AbstractProstate cancer (PC) is one of the most common and socially significant oncological diseases among men. Bioinformatic analysis of omics data allows identifying molecular genetic changes associated with the disease development, as well as markers of prognosis and response to therapy. Alterations in DNA methylation and histone modification profiles widely occur in malignant tumors. In this study, we analyzed changes in DNA methylation in three groups of PC patients based on data from The Cancer Genome Atlas project (TCGA, https://portal.gdc.cancer.gov): (1) high- and intermediate-risk of the tumor progression, (2) favorable and unfavorable prognoses within the high-risk group, and (3) TMPRSS2-ERG-positive (tumors with TMPRSS2-ERG fusion transcript) and TMPRSS2-ERG-free cases within the high-risk group. We found eight CpG sites (cg07548607, cg13533340, cg16643088, cg18467168, cg23324953, cg23753247, cg25773620, and cg27148952) hypermethylated in the high-risk group compared with the intermediate-risk group of PC. Seven differentially methylated CpG sites (cg00063748, cg06834698, cg18607127, cg25273707, cg01704198, cg02067712, and cg02157224) were associated with unfavorable prognosis within the high-risk group. Six CpG sites (cg01138171, cg14060519, cg19570244, cg24492886, cg25605277, and cg26228280) were hypomethylated in TMPRSS2-ERG-positive PC compared to TMPRSS2-ERG-negative tumors within the high-risk group. The CpG sites were localized, predominantly, in regulatory genome regions belonging to promoters of the following genes: ARHGEF4, C6orf141, C8orf86, CLASP2, CSRNP1, GDA, GSX1, IQSEC1, MYOF, OR10A3, PLCD1, PLEC1, PRDM16, PTAFR, RP11-844P9.2, SCYL3, VPS13D, WT1, and ZSWIM2. For these genes, analysis of differential expression and its correlation with CpG site methylation (β-value level) was also performed. In addition, STK33 and PLCD1 had similar changes in colorectal cancer. As for the CSRNP1, the ARHGEF4, and the WT1 genes, misregulated expression levels were mentioned in lung, liver, pancreatic and androgen-independent prostate cancer. The potential impact of changed methylation on the mRNA level was determined for the CSRNP1, STK33, PLCD1, ARHGEF4, WT1, SCYL3, and VPS13D genes. The above CpG sites could be considered as potential prognostic markers of the high-risk group of PC.

scholarly journals Presenting stage and risk group in men dying of prostate cancer

2020 ◽  
Vol 27 (6) ◽  
Author(s):  
S. Parimi ◽  
S. Bondy ◽  
M. Aparicio ◽  
K. Sunderland ◽  
J. Cho ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
British Columbia ◽  
High Risk ◽  
Gleason Score ◽  
Metastatic Disease ◽  
Risk Group ◽  
Specific Antigen ◽  
Population Based ◽  
Low Risk ◽  
Intermediate Risk

Introduction Prostate cancer remains the 3rd leading cause of cancer-related mortality in Canadian men, and yet screening for prostate cancer continues to be controversial because the majority of men diagnosed with prostate cancer do not die of the disease. It also remains uncertain whether treatment of cases that can be treated with curative intent alters the mortality rate. There are very few studies describing the presenting stage, risk groups, and survival after diagnosis for men dying of prostate cancer in the literature. In this study, we explored these characteristics for all men who died of prostate cancer in British Columbia between 2013 and 2015. Methods The population-based BC Cancer databases were used to identify all patients diagnosed between Jan­uary 2013 and December 2015 who died of prostate cancer. Patient, tumour, and treatment characteristics were collected, and the risk grouping for each tumour was determined. The proportion of cases in each risk group at the time of diagnosis was determined. Survival time from diagnosis to death was calculated for all patients and for each risk group using the Kaplan–Meier method. Results A total of 1256 patients died of prostate cancer. Of patients who presented with metastatic disease, 57.2% presented with a Gleason score of 8 or more, compared with only 35.7% of patients who presented with nonmetastatic disease (p < 0.0001). The presenting stage and risk group of those dying of prostate cancer were as follows: 32% met­astatic disease, 3% regional (defined as node-positive), 39% localized high risk, 9% localized intermediate risk, 4% localized low risk, 6% localized not otherwise specified, and 7% unknown. Therefore, 80.3% of those with a known risk group presented with either localized high-risk, regional, or metastatic disease at diagnosis. The median survival times from diagnosis to death were 12 years for localized low-risk, 10 years for localized intermediate-risk, 6.5 years for localized high-risk, 4 years for regional, and 1.7 years for metastatic disease at diagnosis. Conclusions This population-based analysis demonstrates that patients with localized high-risk, regional, or metastatic disease at diagnosis constitute the overwhelming majority of patients who die of prostate cancer in British Columbia. Unless these disease states can reliably be identified at an earlier low- or intermediate-risk localized state in the future, it is unlikely that treatment of localized low- and intermediate-risk cancer will have an impact on sur­vival. Furthermore, patients with de novo metastatic disease had identifiable risk factors of a higher prostate-specific antigen and Gleason score. Further studies are required to confirm these results.

scholarly journals 648 External Validation of The European Randomized Study of Screening for Prostate Cancer Risk Calculator 3 (ERSPC-RC3) In the Detection of Prostate Cancer and Avoiding Unnecessary Prostate Biopsies

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
C Desai ◽  
S A Ehsanullah ◽  
A Bhojwani ◽  
A Dhanasekaran
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Risk Group ◽  
Randomized Study ◽  
External Validation ◽  
Prostate Cancer Risk ◽  
Low Risk ◽  
Intermediate Risk ◽  
Risk Calculator ◽  
Prostate Biopsies

Abstract Introduction The Prostate Cancer Research Foundation – Stichting Wetenschappelijk Onderzoek Prostaatkanker group has devised the European Randomized Study of Screening for Prostate Cancer (CaP) Risk Calculator 3 (ERSPC-RC3) tool which aims to increase prostate cancer detection rates and avoid unnecessary prostate biopsies. We report the external validation and accuracy of the ERSPC-RC3 in our UK cohort. Method Retrospective data was collected for patients who had prostate biopsy at a multi-centre district general hospital over an 18-month period. The ERSPC-RC3 was applied to identify the probability of a positive biopsy for CaP (Gleason score ≥7). Results Out of 121 TRUS biopsies, 78 patients met the ERSPC-RC3 inclusion criteria. Patients were stratified as low-risk (detectable CaP risk &lt;12.5%) n = 10, intermediate-risk (detectable CaP risk 12.5-20%) n = 8, and high-risk (detectable CaP risk &gt;20%) n = 60 groups. All low-risk patients had a benign histology. Gleason 7 CaP was found in 37.5% from the intermediate-risk group and 41.7% in the high-risk group respectively. Conclusions Our results demonstrate that using ERSPC-RC3 could have prevented 44% (n = 34) of patients from having unnecessary biopsies. We recommend the use of ERSPC-RC3 to risk stratify patients being investigated for suspected CaP.

The likelihood of death from prostate cancer in men with favorable or unfavorable intermediate-risk disease.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 42-42
Author(s):  
Florence K. Keane ◽  
Ming-Hui Chen ◽  
Danjie Zhang ◽  
Marian J. Loffredo ◽  
Philip W. Kantoff ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Risk Group ◽  
Study Cohort ◽  
Intermediate Risk ◽  
Significant Difference ◽  
Risk Prostate Cancer ◽  
Available Information

42 Background: Recently men with intermediate-risk prostate cancer (PC) were classified into favorable and unfavorable categories but whether the risk of PC-specific mortality (PCSM) amongst men with high-risk PC is higher compared to men with unfavorable intermediate-risk PC is unknown. Methods: In a prospective randomized trial conducted between 1995 and 2001, 206 men with intermediate or high-risk PC were randomized to 70 Gy with or without six months of androgen suppression therapy (AST). The subgroup of 197 patients with available information on percent positive biopsies formed the study cohort. Fine and Gray’s regression was used to assess whether men with high-risk PC had a significantly higher risk of PCSM compared to men with unfavorable intermediate-risk PC, adjusting for age, treatment, and comorbidity category. Results: After a median follow-up of 14.3 years there were 127 deaths (64.5%), of which 22 (17.3%) were from PC. There were no PC deaths in the favorable intermediate-risk group. There was no significant increase in the risk of PCSM in men with high-risk compared to unfavorable intermediate-risk PC (Adjusted Hazard Ratio: 1.59; 95% Confidence Interval: 0.66 to 3.83; P= 0.30) after adjusting for age, randomized treatment arm and comorbidity. Conclusions: Given no significant difference in the risk of PCSM in unfavorable intermediate compared with high-risk PC, these patients may merit treatment with RT and long-term AST. The lack of PC deaths in the favorable intermediate-risk group suggests that adding AST may not reduce the risk of PCSM in these patients. [Table: see text]

Sign in / Sign up

Export Citation Format

Share Document