Prostate cancer-specific mortality after radical prostatectomy or external beam radiation therapy in men with 1 or more high-risk factors

✍ Scribed by Anthony V. D'Amico; Ming-Hui Chen; William J. Catalona; Leon Sun; Kimberly A. Roehl; Judd W. Moul

• Publisher: John Wiley and Sons
• Year: 2007
• Tongue: English
• Weight: 292 KB
• Volume: 110
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/cncr.22737

✦ Synopsis

Abstract

BACKGROUND.

Estimates of prostate cancer‐specific mortality (PCSM) were determined after radical prostatectomy (RP) or radiation therapy (RT) in men with ≥1 high‐risk factors.

METHODS.

The study cohort comprised 948 men who underwent RP (N = 660) or RT (N = 288) for localized prostate cancer between 1988 and 2004 and had at least 1 of the following high‐risk factors: a prostate‐specific antigen (PSA) velocity >2 ng/mL/year during the year before diagnosis, a biopsy Gleason score of ≥7, a PSA level of ≥10 ng/mL, or clinical category T2b or high disease. Grays regression was used to evaluate whether the number and type of high‐risk factors were associated with time to PCSM.

RESULTS.

Multiple determinants of high risk were found to be significantly associated with a shorter time to PCSM after RP (P < .001) or RT (P ≤ .001). The solitary presence of a PSA velocity >2 ng/mL/year was associated with an increased risk of PCSM after RP (hazards ratio [HR] of 7.3; 95% confidence interval [95% CI], 1.0–59 [P = .05]) or RT (HR of 12.1; 95% CI, 1.4–105 [P = .02]) when compared with men with any other single high‐risk factor.

CONCLUSIONS.

Men with a PSA velocity >2 ng/mL/year had a significantly higher risk of PCSM compared with men who had any other single high‐risk factor. These men should be considered for randomized trials evaluating the impact on PCSM from adding systemic agents to standards of care for men with high‐risk PC. Cancer 2007. © 2007 American Cancer Society.