Risk and timing of biochemical recurrence in pT3aN0/Nx prostate cancer with positive surgical margin - A multicenter study
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Risk and timing of biochemical recurrence in pT3aN0/Nx prostate cancer with positive surgical margin - A multicenter study. / Karl, Alexander; Buchner, Alexander; Tympner, Christiane; Kirchner, Thomas; Ganswindt, Ute; Belka, Claus; Ganzer, Roman; Wieland, Wolf; Eder, Fabian; Hofstädter, Ferdinand; Schilling, David; Sievert, Karl-Dietrich; Stenzl, Arnulf; Scharpf, Marcus; Fend, Falko; Vom Dorp, Frank; Rübben, Herbert; Kurt Werner, Schmid; Porres-Knoblauch, Daniel; Heidenreich, Axel; Hangarter, Birgit; Knüchel-Clarke, Ruth; Rogenhofer, Michael; Wullich, Bernd; Hartmann, Arndt; Comploj, Evi; Pycha, Armin; Hanspeter, Esther; Pehrke, Dirk; Sauter, Guido; Graefen, Markus; Gratzke, Christian; Stief, Christian; Wiegel, Thomas; Haese, Alexander.
In: RADIOTHER ONCOL, Vol. 116, No. 1, 07.2015, p. 119-24.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Risk and timing of biochemical recurrence in pT3aN0/Nx prostate cancer with positive surgical margin - A multicenter study
AU - Karl, Alexander
AU - Buchner, Alexander
AU - Tympner, Christiane
AU - Kirchner, Thomas
AU - Ganswindt, Ute
AU - Belka, Claus
AU - Ganzer, Roman
AU - Wieland, Wolf
AU - Eder, Fabian
AU - Hofstädter, Ferdinand
AU - Schilling, David
AU - Sievert, Karl-Dietrich
AU - Stenzl, Arnulf
AU - Scharpf, Marcus
AU - Fend, Falko
AU - Vom Dorp, Frank
AU - Rübben, Herbert
AU - Kurt Werner, Schmid
AU - Porres-Knoblauch, Daniel
AU - Heidenreich, Axel
AU - Hangarter, Birgit
AU - Knüchel-Clarke, Ruth
AU - Rogenhofer, Michael
AU - Wullich, Bernd
AU - Hartmann, Arndt
AU - Comploj, Evi
AU - Pycha, Armin
AU - Hanspeter, Esther
AU - Pehrke, Dirk
AU - Sauter, Guido
AU - Graefen, Markus
AU - Gratzke, Christian
AU - Stief, Christian
AU - Wiegel, Thomas
AU - Haese, Alexander
N1 - Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
PY - 2015/7
Y1 - 2015/7
N2 - BACKGROUND AND PURPOSE: Positive surgical margins (PSM) after radical prostatectomy have been shown to be associated with impaired outcome. In pT3pN0 patients with PSM either immediate radiotherapy or clinical and biological monitoring followed by salvage radiotherapy is recommended by the latest guidelines of the European Association of Urology.MATERIALS AND METHODS: A retrospective, multicenter study of eight urological centers was conducted on 536 prostatectomy patients with pT3aN0/NxR1 tumors and no neoadjuvant/adjuvant therapy. A pathological re-review of all prostate specimens was performed. Association of clinical and pathological features with biochemical recurrence (BCR) was analyzed using univariate and multivariate analysis.RESULTS: With 48months median follow-up, BCR occurred in 39.7%. Preoperative PSA value, performance of pelvic lymph node dissection and Gleason score were significantly associated with BCR. In multivariate analysis, Gleason score was the only independent prognostic factor (p<0.001) for BCR. Five-year BCR-free survival rates were 74%, 70%, 38%, and 51% with Gleason score 6, 3+4=7a, 4+3=7b, and 8-10, respectively.CONCLUSIONS: In pT3aN0/NxR1 patients with no adjuvant/neoadjuvant treatment, Gleason Score permits independent prediction of the risk for BCR. These findings could help to estimate and discuss the individual risk for BCR with our patients on an individual basis.
AB - BACKGROUND AND PURPOSE: Positive surgical margins (PSM) after radical prostatectomy have been shown to be associated with impaired outcome. In pT3pN0 patients with PSM either immediate radiotherapy or clinical and biological monitoring followed by salvage radiotherapy is recommended by the latest guidelines of the European Association of Urology.MATERIALS AND METHODS: A retrospective, multicenter study of eight urological centers was conducted on 536 prostatectomy patients with pT3aN0/NxR1 tumors and no neoadjuvant/adjuvant therapy. A pathological re-review of all prostate specimens was performed. Association of clinical and pathological features with biochemical recurrence (BCR) was analyzed using univariate and multivariate analysis.RESULTS: With 48months median follow-up, BCR occurred in 39.7%. Preoperative PSA value, performance of pelvic lymph node dissection and Gleason score were significantly associated with BCR. In multivariate analysis, Gleason score was the only independent prognostic factor (p<0.001) for BCR. Five-year BCR-free survival rates were 74%, 70%, 38%, and 51% with Gleason score 6, 3+4=7a, 4+3=7b, and 8-10, respectively.CONCLUSIONS: In pT3aN0/NxR1 patients with no adjuvant/neoadjuvant treatment, Gleason Score permits independent prediction of the risk for BCR. These findings could help to estimate and discuss the individual risk for BCR with our patients on an individual basis.
KW - Adult
KW - Aged
KW - Humans
KW - Lymph Node Excision
KW - Male
KW - Middle Aged
KW - Multivariate Analysis
KW - Neoplasm Grading
KW - Prostate-Specific Antigen
KW - Prostatectomy
KW - Prostatic Neoplasms
KW - Recurrence
KW - Retrospective Studies
KW - Risk
KW - Salvage Therapy
KW - Survival Rate
U2 - 10.1016/j.radonc.2015.06.021
DO - 10.1016/j.radonc.2015.06.021
M3 - SCORING: Journal article
C2 - 26138059
VL - 116
SP - 119
EP - 124
JO - RADIOTHER ONCOL
JF - RADIOTHER ONCOL
SN - 0167-8140
IS - 1
ER -