Journal article
Long-term Outcome of Prostate Cancer Patients Who Exhibit Biochemical Failure Despite Salvage Radiation Therapy After Radical Prostatectomy
American journal of clinical oncology, Vol.40(6), pp.612-620
12/2017
DOI: 10.1097/COC.0000000000000207
PMID: 26165416
Abstract
Salvage radiation therapy (SRT) is an effective treatment for recurrent prostate cancer (PCa) after radical prostatectomy. We report the long-term outcome of men who developed biochemical recurrence (BCR) after SRT and were treated >14 years ago. In total, 61 patients treated with SRT from 1992 to 2000 at our institution were identified. Survival was calculated by Kaplan-Meier method. Log-rank test and Cox regression were used to determine significance of clinical parameters. The median follow-up was 126 months (interquartile range, 66-167 mo). Thirty-four (56%) had prostate-specific antigen (PSA) failure after SRT. At 10 years, overall survival (OS) was 67%, freedom from PSA failure (FFPF) was 33%, prostate cancer-specific survival (PCSS) was 84%, and distant metastases-free survival (DMFS) was 84%. Pathologic T-stage, Gleason score, seminal vesicle involvement, and pre-SRT PSA were associated with FFPF. For patients who failed SRT, the median time to BCR after SRT was 30 mo. A total of 19 (68%) received androgen deprivation therapy. The median OS was 13.6 years. At 10 years from time of BCR, OS was 59%, PCSS was 73%, DMFS was 75%, and castration-resistant-free survival was 70%. Early SRT failure correlated with significantly decreased DMFS and PCSS. Ten-year DMFS from SRT was 43% (BCR≤1 y) versus 91% (BCR>1 y). Extended follow-up demonstrates that despite SRT failure, PCSS remains high in select patients. Early failure (≤1 y after SRT) predicted for significantly worse outcome and may represent a subgroup with more aggressive disease that may be considered for further prospective clinical studies.
Details
- Title: Subtitle
- Long-term Outcome of Prostate Cancer Patients Who Exhibit Biochemical Failure Despite Salvage Radiation Therapy After Radical Prostatectomy
- Creators
- James Ying - Departments of Radiation OncologyChiachien J Wang - Departments of Radiation OncologyJingsheng Yan - Clinical ScienceStanley L Liauw - Department of Radiation Oncology, University of Chicago, Chicago, ILChristopher Straka - Departments of Radiation OncologyDavid Pistenmaa - Departments of Radiation OncologyXian-Jin Xie - Clinical ScienceYair Lotan - Urology, University of Texas at Southwestern Medical Center, DallasClaus Roehrborn - Urology, University of Texas at Southwestern Medical Center, DallasD Nathan Kim - Department of Radiation Oncology, Texas Oncology, Waco, TX
- Resource Type
- Journal article
- Publication Details
- American journal of clinical oncology, Vol.40(6), pp.612-620
- Publisher
- United States
- DOI
- 10.1097/COC.0000000000000207
- PMID
- 26165416
- ISSN
- 0277-3732
- eISSN
- 1537-453X
- Language
- English
- Date published
- 12/2017
- Academic Unit
- Preventive and Community Dentistry; Biostatistics; Dental Research
- Record Identifier
- 9983917671502771
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