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INTERMEDIATE TERM BIOCHEMICAL PROGRESSION RATES AFTER RADICAL PROSTATECTOMY AND RADIOTHERAPY IN PATIENTS WITH SCREEN DETECTED PROSTATE CANCER

2005; Lippincott Williams & Wilkins; Volume: 174; Issue: 1 Linguagem: Inglês

10.1097/01.ju.0000162051.15616.70

1527-3792

Julie Krygiel, Deborah S. Smith, Sharon M. Homan, Walton Sumner, Robert F. Nease, Ross C. Brownson, William J. Catàlona,

Bladder and Urothelial Cancer Treatments

No AccessJournal of UrologyAdult Urology: Oncology: Prostate/Testis/Penis/Urethra1 Jul 2005INTERMEDIATE TERM BIOCHEMICAL PROGRESSION RATES AFTER RADICAL PROSTATECTOMY AND RADIOTHERAPY IN PATIENTS WITH SCREEN DETECTED PROSTATE CANCER JULIE M. KRYGIEL, DEBORAH S. SMITH, SHARON M. HOMAN, WALTON SUMNER, ROBERT F. NEASE, ROSS C. BROWNSON, and WILLIAM J. CATALONA JULIE M. KRYGIELJULIE M. KRYGIEL Written as part of Ph.D. dissertation, School of Public Health, Saint Louis University. Nothing to disclose. More articles by this author , DEBORAH S. SMITHDEBORAH S. SMITH Nothing to disclose. More articles by this author , SHARON M. HOMANSHARON M. HOMAN Nothing to disclose. More articles by this author , WALTON SUMNERWALTON SUMNER Nothing to disclose. More articles by this author , ROBERT F. NEASEROBERT F. NEASE Nothing to disclose. More articles by this author , ROSS C. BROWNSONROSS C. BROWNSON Nothing to disclose. More articles by this author , and WILLIAM J. CATALONAWILLIAM J. CATALONA Financial interest and/or other relationship with Beckman Coulter, Inc. More articles by this author View All Author Informationhttps://doi.org/10.1097/01.ju.0000162051.15616.70AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We compared biochemical progression rates measured by increasing prostate specific antigen (PSA) levels using a standard definition of biochemical recurrence among patients with screen detected prostate cancer treated with radical prostatectomy (RP) or radiotherapy (RT). Materials and Methods: A total of 1,939 patients diagnosed with clinically localized prostate cancer in a community based screening study from 1989 to 1998, followed through 2001, were treated with RP or RT and agreed to enroll in a followup study. This prospective cohort study (median followup 62 months, range 0.2 to 141) used adjusted Cox proportional hazards models to examine time to progression. Selection bias was addressed with propensity scores. Biochemical evidence of cancer progression was defined as PSA greater than 0.2 ng/ml in patients who underwent RP and 3 consecutive PSA increases as recommended by the American Society for Therapeutic Radiology and Oncology criteria for radiotherapy. Results: Of the patients 17% had evidence of cancer progression. The percentage with progression-free survival at 5 and 9 years for RP was 84% and 76%, respectively, and for RT 80% and 70%, respectively. Cox proportional hazards models produced a hazard ratio of 1.63 (95% CI, 1.12, 2.38) for RT compared with RP, adjusting for clinical stage, Gleason grade, preoperative PSA, biopsy age, treatment year and propensity for treatment type. Conclusions: With intermediate term followup, patients treated with RT were more likely to have cancer progression than with RP adjusting for demographics, clinical factors, selection bias and treatment year. References 1 : The early detection of prostate carcinoma with prostate specific antigen: the Washington University experience. Cancer1997; 80: 1852. Crossref, Medline, Google Scholar 2 : Detection of organ-confined prostate cancer is increased through prostate-specific antigen-based screening. JAMA1993; 270: 948. Crossref, Medline, Google Scholar 3 : Longitudinal screening for prostate cancer with prostate-specific antigen. JAMA1996; 276: 1309. Crossref, Medline, Google Scholar 4 : Measurement of prostate-specific antigen in serum as a screening test for prostate cancer. N Engl J Med1991; 324: 1156. Crossref, Medline, Google Scholar 5 : Quality-of-life outcomes for men with prostate carcinoma detected by screening. Cancer2000; 88: 1454. 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Link, Google Scholar From Waterman Research Solutions (JMK), School of Public Health, Saint Louis University (SMH, RCB), Division of General Medical Sciences, Department of Internal Medicine, Washington University School of Medicine (WS), St. Louis, and Express Scripts, Inc., Maryland Heights, Missouri (RFN), the Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan (DSS), and the Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois (WJC)© 2005 by American Urological Association, Inc.FiguresReferencesRelatedDetails Volume 174Issue 1July 2005Page: 126-130 Advertisement Copyright & Permissions© 2005 by American Urological Association, Inc.Keywordsradiotherapydisease progressionprostatectomyprostatic neoplasmsprostate-specific antigenMetrics Author Information JULIE M. KRYGIEL Written as part of Ph.D. dissertation, School of Public Health, Saint Louis University. Nothing to disclose. More articles by this author DEBORAH S. SMITH Nothing to disclose. More articles by this author SHARON M. HOMAN Nothing to disclose. More articles by this author WALTON SUMNER Nothing to disclose. More articles by this author ROBERT F. NEASE Nothing to disclose. More articles by this author ROSS C. BROWNSON Nothing to disclose. More articles by this author WILLIAM J. CATALONA Financial interest and/or other relationship with Beckman Coulter, Inc. More articles by this author Expand All Advertisement PDF downloadLoading ...