Definition of high-risk prostate cancer impacts oncological outcomes after radical prostatectomy

Sophie Knipper; Pierre I Karakiewicz; Alexander Heinze; Felix Preisser; Thomas Steuber; Hartwig Huland; Markus Graefen; Derya Tilki

doi:10.1016/j.urolonc.2019.12.014

Definition of high-risk prostate cancer impacts oncological outcomes after radical prostatectomy

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Definition of high-risk prostate cancer impacts oncological outcomes after radical prostatectomy. / Knipper, Sophie; Karakiewicz, Pierre I; Heinze, Alexander; Preisser, Felix; Steuber, Thomas; Huland, Hartwig; Graefen, Markus; Tilki, Derya.

In: UROL ONCOL-SEMIN ORI, Vol. 38, No. 4, 04.2020, p. 184-190.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Knipper, S, Karakiewicz, PI, Heinze, A, Preisser, F, Steuber, T, Huland, H, Graefen, M & Tilki, D 2020, 'Definition of high-risk prostate cancer impacts oncological outcomes after radical prostatectomy', UROL ONCOL-SEMIN ORI, vol. 38, no. 4, pp. 184-190. https://doi.org/10.1016/j.urolonc.2019.12.014

APA

Knipper, S., Karakiewicz, P. I., Heinze, A., Preisser, F., Steuber, T., Huland, H., Graefen, M., & Tilki, D. (2020). Definition of high-risk prostate cancer impacts oncological outcomes after radical prostatectomy. UROL ONCOL-SEMIN ORI, 38(4), 184-190. https://doi.org/10.1016/j.urolonc.2019.12.014

Vancouver

Knipper S, Karakiewicz PI, Heinze A, Preisser F, Steuber T, Huland H et al. Definition of high-risk prostate cancer impacts oncological outcomes after radical prostatectomy. UROL ONCOL-SEMIN ORI. 2020 Apr;38(4):184-190. https://doi.org/10.1016/j.urolonc.2019.12.014

Bibtex

@article{7cc5021570394a0fbd8a1efaee5ba556,

title = "Definition of high-risk prostate cancer impacts oncological outcomes after radical prostatectomy",

abstract = "BACKGROUND: To examine the impact of different pretreatment definitions on biochemical recurrence (BCR)-free survival, metastasis-free survival, and cancer-specific survival after radical prostatectomy.METHODS: Overall, 26,364 patients with clinically localized disease who underwent radical prostatectomy at a single institution (1992-2017) were retrospectively analyzed. Seven pretreatment definitions of high-risk CaP (prostate-specific antigen [PSA] ≥20 ng/ml, clinical stage ≥T2c, clinical stage T3 [cT3], biopsy Gleason score [GS] 8-10 [Grade Group {GG} IV-V], biopsy GS 9 to 10 [GG V], D'Amico risk definition, National Comprehensive Cancer Network risk definition) were evaluated. Kaplan-Meier, as well as multivariable Cox regression analyses were used.RESULTS: Depending on the definition, patients with high-risk CaP comprised between 0.9% (cT3) and 20.3% (D'Amico high-risk) of the population. Ten-year BCR-free survival rates varied from 36.0% (≥cT2c) to 47.4% (National Comprehensive Cancer Network high-risk). Ten-year metastasis-free survival rates varied from 56.6% (GS 9-10/GG V) to 77.5% (PSA ≥ 20 ng/ml). Ten-year cancer-specific survival rates varied from 86.6% (cT3) to 94.5% (PSA ≥ 20 ng/ml). In multivariable analysis, all high-risk definitions were associated with significantly higher risk of BCR (hazard ratio [HR]: 3.4-3.9), metastatic progression (HR: 3.9-8.8), and cancer-specific mortality (HR: 2.8-11.2).CONCLUSIONS: Variety in outcomes exists, depending on the pretreatment definition of high-risk CaP. Among the tested, GS 9 to 10 (GG V), cT2c, and cT3 were the strongest predictor for higher BCR risk, cT3 was the strongest predictor for higher metastatic progression risk and GS 9 to 10 (GG V) was the strongest predictor for higher cancer-specific mortality risk in multivariable analyses.",

author = "Sophie Knipper and Karakiewicz, {Pierre I} and Alexander Heinze and Felix Preisser and Thomas Steuber and Hartwig Huland and Markus Graefen and Derya Tilki",

year = "2020",

month = apr,

doi = "10.1016/j.urolonc.2019.12.014",

language = "English",

volume = "38",

pages = "184--190",

journal = "UROL ONCOL-SEMIN ORI",

issn = "1078-1439",

publisher = "Elsevier Inc.",

number = "4",

}

RIS

TY - JOUR

T1 - Definition of high-risk prostate cancer impacts oncological outcomes after radical prostatectomy

AU - Knipper, Sophie

AU - Karakiewicz, Pierre I

AU - Heinze, Alexander

AU - Preisser, Felix

AU - Steuber, Thomas

AU - Huland, Hartwig

AU - Graefen, Markus

AU - Tilki, Derya

PY - 2020/4

Y1 - 2020/4

N2 - BACKGROUND: To examine the impact of different pretreatment definitions on biochemical recurrence (BCR)-free survival, metastasis-free survival, and cancer-specific survival after radical prostatectomy.METHODS: Overall, 26,364 patients with clinically localized disease who underwent radical prostatectomy at a single institution (1992-2017) were retrospectively analyzed. Seven pretreatment definitions of high-risk CaP (prostate-specific antigen [PSA] ≥20 ng/ml, clinical stage ≥T2c, clinical stage T3 [cT3], biopsy Gleason score [GS] 8-10 [Grade Group {GG} IV-V], biopsy GS 9 to 10 [GG V], D'Amico risk definition, National Comprehensive Cancer Network risk definition) were evaluated. Kaplan-Meier, as well as multivariable Cox regression analyses were used.RESULTS: Depending on the definition, patients with high-risk CaP comprised between 0.9% (cT3) and 20.3% (D'Amico high-risk) of the population. Ten-year BCR-free survival rates varied from 36.0% (≥cT2c) to 47.4% (National Comprehensive Cancer Network high-risk). Ten-year metastasis-free survival rates varied from 56.6% (GS 9-10/GG V) to 77.5% (PSA ≥ 20 ng/ml). Ten-year cancer-specific survival rates varied from 86.6% (cT3) to 94.5% (PSA ≥ 20 ng/ml). In multivariable analysis, all high-risk definitions were associated with significantly higher risk of BCR (hazard ratio [HR]: 3.4-3.9), metastatic progression (HR: 3.9-8.8), and cancer-specific mortality (HR: 2.8-11.2).CONCLUSIONS: Variety in outcomes exists, depending on the pretreatment definition of high-risk CaP. Among the tested, GS 9 to 10 (GG V), cT2c, and cT3 were the strongest predictor for higher BCR risk, cT3 was the strongest predictor for higher metastatic progression risk and GS 9 to 10 (GG V) was the strongest predictor for higher cancer-specific mortality risk in multivariable analyses.

AB - BACKGROUND: To examine the impact of different pretreatment definitions on biochemical recurrence (BCR)-free survival, metastasis-free survival, and cancer-specific survival after radical prostatectomy.METHODS: Overall, 26,364 patients with clinically localized disease who underwent radical prostatectomy at a single institution (1992-2017) were retrospectively analyzed. Seven pretreatment definitions of high-risk CaP (prostate-specific antigen [PSA] ≥20 ng/ml, clinical stage ≥T2c, clinical stage T3 [cT3], biopsy Gleason score [GS] 8-10 [Grade Group {GG} IV-V], biopsy GS 9 to 10 [GG V], D'Amico risk definition, National Comprehensive Cancer Network risk definition) were evaluated. Kaplan-Meier, as well as multivariable Cox regression analyses were used.RESULTS: Depending on the definition, patients with high-risk CaP comprised between 0.9% (cT3) and 20.3% (D'Amico high-risk) of the population. Ten-year BCR-free survival rates varied from 36.0% (≥cT2c) to 47.4% (National Comprehensive Cancer Network high-risk). Ten-year metastasis-free survival rates varied from 56.6% (GS 9-10/GG V) to 77.5% (PSA ≥ 20 ng/ml). Ten-year cancer-specific survival rates varied from 86.6% (cT3) to 94.5% (PSA ≥ 20 ng/ml). In multivariable analysis, all high-risk definitions were associated with significantly higher risk of BCR (hazard ratio [HR]: 3.4-3.9), metastatic progression (HR: 3.9-8.8), and cancer-specific mortality (HR: 2.8-11.2).CONCLUSIONS: Variety in outcomes exists, depending on the pretreatment definition of high-risk CaP. Among the tested, GS 9 to 10 (GG V), cT2c, and cT3 were the strongest predictor for higher BCR risk, cT3 was the strongest predictor for higher metastatic progression risk and GS 9 to 10 (GG V) was the strongest predictor for higher cancer-specific mortality risk in multivariable analyses.

U2 - 10.1016/j.urolonc.2019.12.014

DO - 10.1016/j.urolonc.2019.12.014

M3 - SCORING: Journal article

C2 - 31928867

VL - 38

SP - 184

EP - 190

JO - UROL ONCOL-SEMIN ORI

JF - UROL ONCOL-SEMIN ORI

SN - 1078-1439

IS - 4

ER -