Long-term cancer control outcomes in patients with biochemical recurrence and the impact of time from radical prostatectomy to biochemical recurrence
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Long-term cancer control outcomes in patients with biochemical recurrence and the impact of time from radical prostatectomy to biochemical recurrence. / Pompe, Raisa S; Gild, Philipp; Karakiewicz, Pierre I; Bock, Lea-Philine; Schlomm, Thorsten; Steuber, Thomas; Graefen, Markus; Huland, Hartwig; Tian, Zhe; Tilki, Derya.
In: PROSTATE, Vol. 78, No. 9, 06.2018, p. 676-681.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Long-term cancer control outcomes in patients with biochemical recurrence and the impact of time from radical prostatectomy to biochemical recurrence
AU - Pompe, Raisa S
AU - Gild, Philipp
AU - Karakiewicz, Pierre I
AU - Bock, Lea-Philine
AU - Schlomm, Thorsten
AU - Steuber, Thomas
AU - Graefen, Markus
AU - Huland, Hartwig
AU - Tian, Zhe
AU - Tilki, Derya
N1 - © 2018 Wiley Periodicals, Inc.
PY - 2018/6
Y1 - 2018/6
N2 - BACKGROUND: Rates of metastatic progression (MP) and prostate cancer mortality (PCSM) are variable after biochemical recurrence (BCR) in patients who underwent radical prostatectomy (RP). To describe long-term oncological outcomes of BCR patients and to analyze risk factors for further outcomes in these men with a special focus on RP-BCR time.METHODS: We retrospectively analyzed the data of 5509 RP patients treated between 1992 and 2006. Of those, we included 1321 patients who experienced BCR (PSA level ≥0.2 ng/mL) and did not receive any neoadjuvant or adjuvant therapy. Kaplan-Meier and time dependent Cox regression models were used.RESULTS: Median follow-up was 121 months. MP was recorded in 177 (13.4%), PCSM in 126 (9.5%), and overall mortality (OM) in 264 (20.0%) patients. Patients with MP had worse tumor characteristics such as higher Gleason Scores (GS), rapid PSA doubling-time (DT), and shorter RP-BCR time intervals. MP-free, PCSM-free, and overall survival rates were significantly worse in patients with RP-BCR time of <12 months versus patients with 12-35.9 or ≥36 months (P ≤ 0.001). Besides higher GS and rapid PSA-DT, RP-BCR time independently predicted MP, PCSM, and OM in multivariable regression analyses. Relative to the intermediate and longest RP-BCR time interval, the shortest interval (<12) carried the highest risk for all three endpoints.CONCLUSIONS: Only a small proportion of BCR patients proceed to MP or PCSM. Besides higher GS and rapid PSA-DT a shorter RP-BCR interval (<12 months) heralds the most aggressive phenotype for progression to all three examined endpoints: MP, PCSM, and OM.
AB - BACKGROUND: Rates of metastatic progression (MP) and prostate cancer mortality (PCSM) are variable after biochemical recurrence (BCR) in patients who underwent radical prostatectomy (RP). To describe long-term oncological outcomes of BCR patients and to analyze risk factors for further outcomes in these men with a special focus on RP-BCR time.METHODS: We retrospectively analyzed the data of 5509 RP patients treated between 1992 and 2006. Of those, we included 1321 patients who experienced BCR (PSA level ≥0.2 ng/mL) and did not receive any neoadjuvant or adjuvant therapy. Kaplan-Meier and time dependent Cox regression models were used.RESULTS: Median follow-up was 121 months. MP was recorded in 177 (13.4%), PCSM in 126 (9.5%), and overall mortality (OM) in 264 (20.0%) patients. Patients with MP had worse tumor characteristics such as higher Gleason Scores (GS), rapid PSA doubling-time (DT), and shorter RP-BCR time intervals. MP-free, PCSM-free, and overall survival rates were significantly worse in patients with RP-BCR time of <12 months versus patients with 12-35.9 or ≥36 months (P ≤ 0.001). Besides higher GS and rapid PSA-DT, RP-BCR time independently predicted MP, PCSM, and OM in multivariable regression analyses. Relative to the intermediate and longest RP-BCR time interval, the shortest interval (<12) carried the highest risk for all three endpoints.CONCLUSIONS: Only a small proportion of BCR patients proceed to MP or PCSM. Besides higher GS and rapid PSA-DT a shorter RP-BCR interval (<12 months) heralds the most aggressive phenotype for progression to all three examined endpoints: MP, PCSM, and OM.
KW - Journal Article
U2 - 10.1002/pros.23511
DO - 10.1002/pros.23511
M3 - SCORING: Journal article
C2 - 29570821
VL - 78
SP - 676
EP - 681
JO - PROSTATE
JF - PROSTATE
SN - 0270-4137
IS - 9
ER -