A STANDARD DEFINITION OF DISEASE FREEDOM IS NEEDED FOR PROSTATE CANCER: UNDETECTABLE PROSTATE SPECIFIC ANTIGEN COMPARED WITH THE AMERICAN SOCIETY OF THERAPEUTIC RADIOLOGY AND ONCOLOGY CONSENSUS DEFINITION
2002; Lippincott Williams & Wilkins; Volume: 167; Issue: 3 Linguagem: Inglês
10.1016/s0022-5347(05)65288-3
ISSN1527-3792
Autores Tópico(s)Statistical Methods in Clinical Trials
ResumoNo AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Mar 2002A STANDARD DEFINITION OF DISEASE FREEDOM IS NEEDED FOR PROSTATE CANCER: UNDETECTABLE PROSTATE SPECIFIC ANTIGEN COMPARED WITH THE AMERICAN SOCIETY OF THERAPEUTIC RADIOLOGY AND ONCOLOGY CONSENSUS DEFINITION FRANK A. CRITZ FRANK A. CRITZFRANK A. CRITZ View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)65288-3AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Freedom from prostate cancer is defined by undetectable prostate specific antigen (PSA) after surgery and the American Society of Therapeutic Radiology and Oncology (ASTRO) criteria are recommended for irradiation. Whether these definitions of disease freedom are comparable was evaluated in this study. Materials and Methods: From August 1992 to August 1996 simultaneous irradiation with prostate 125iodine implantation followed by external beam irradiation was performed in 591 consecutive men with stage T1T2NX prostate cancer. All patients had a transperineal implant and none received neoadjuvant hormones. Disease freedom was defined by a PSA cutoff of 0.2 ng./ml. and the ASTRO consensus definition. Median followup was 6 years (range 5 to 8). Results: Of the 591 men in this study 65 had recurrence by ASTRO criteria and 93 had recurrence by a PSA cutoff of 0.2 ng./ml., which was a significant difference (p = 0.001). On multivariate analysis of the factors related to disease-free status the definition of disease freedom, pretreatment PSA and Gleason score were highly significant. Of the 528 men with a minimum 5-year PSA followup the 8-year disease-free survival rate by ASTRO criteria was 99% in those who achieved a PSA nadir of 0.2 ng./ml. and 16% in those with a nadir of 0.3 to 1 ng./ml. Of the 469 disease-free patients by ASTRO criteria with a minimum 5-year followup 455 (97%) achieved a PSA nadir of 0.2 ng./ml. or less. Conclusions: The definition of freedom from prostate cancer significantly affects treatment results. A standard definition is needed and a PSA cutoff of 0.2 ng./ml. is suggested as the standard for all curative treatments for localized prostate cancer. References 1 : Prostate-specific antigen after anatomic radical retropubic prostatectomy. Urol Clin North Am1997; 24: 395. Google Scholar 2 : Radical prostatectomy for stage A adenocarcinoma of the prostate: staging errors and their implications for treatment recommendations and disease outcome. J Urol1991; 146: 1053. 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Google Scholar From the Radiotherapy Clinics of Georgia, Decatur, Georgia© 2002 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byCritz F, Benton J, Shrake P and Merlin M (2012) 25-Year Disease-Free Survival Rate After Irradiation for Prostate Cancer Calculated with the Prostate Specific Antigen Definition of Recurrence Used for Radical ProstatectomyJournal of Urology, VOL. 189, NO. 3, (878-883), Online publication date: 1-Mar-2013.Cookson M, Aus G, Burnett A, Canby-Hagino E, D’Amico A, Dmochowski R, Eton D, Forman J, Goldenberg S, Hernandez J, Higano C, Kraus S, Moul J, Tangen C, Thrasher J and Thompson I (2018) Variation in the Definition of Biochemical Recurrence in Patients Treated for Localized Prostate Cancer: The American Urological Association Prostate Guidelines for Localized Prostate Cancer Update Panel Report and Recommendations for a Standard in the Reporting of Surgical OutcomesJournal of Urology, VOL. 177, NO. 2, (540-545), Online publication date: 1-Feb-2007.KUBAN D, THAMES H and SHIPLEY W (2018) DEFINING RECURRENCE AFTER RADIATION FOR PROSTATE CANCERJournal of Urology, VOL. 173, NO. 6, (1871-1878), Online publication date: 1-Jun-2005.VICINI F, VARGAS C, ABNER A, KESTIN L, HORWITZ E and MARTINEZ A (2018) LIMITATIONS IN THE USE OF SERUM PROSTATE SPECIFIC ANTIGEN LEVELS TO MONITOR PATIENTS AFTER TREATMENT FOR PROSTATE CANCERJournal of Urology, VOL. 173, NO. 5, (1456-1462), Online publication date: 1-May-2005.HORWITZ E, THAMES H, KUBAN D, LEVY L, KUPELIAN P, MARTINEZ A, MICHALSKI J, PISANSKY T, SANDLER H, SHIPLEY W, ZELEFSKY M, HANKS G and ZIETMAN A (2018) DEFINITIONS OF BIOCHEMICAL FAILURE THAT BEST PREDICT CLINICAL FAILURE IN PATIENTS WITH PROSTATE CANCER TREATED WITH EXTERNAL BEAM RADIATION ALONE: A MULTI-INSTITUTIONAL POOLED ANALYSISJournal of Urology, VOL. 173, NO. 3, (797-802), Online publication date: 1-Mar-2005.CRITZ F and LEVINSON K (2018) 10-YEAR DISEASE-FREE SURVIVAL RATES AFTER SIMULTANEOUS IRRADIATION FOR PROSTATE CANCER WITH A FOCUS ON CALCULATION METHODOLOGYJournal of Urology, VOL. 172, NO. 6 Part 1, (2232-2238), Online publication date: 1-Dec-2004.CRITZ F, WILLIAMS W, LEVINSON A, BENTON J, SCHNELL F, HOLLADAY C and SHRAKE P (2018) Prostate Specific Antigen Bounce After Simultaneous Irradiation for Prostate Cancer: The Relationship to Patient AgeJournal of Urology, VOL. 170, NO. 5, (1864-1867), Online publication date: 1-Nov-2003.HORWITZ E, UZZO R, HANLON A, GREENBERG R, HANKS G and POLLACK A (2018) Modifying the American Society for Therapeutic Radiology and Oncology Definition of Biochemical Failure to Minimize the Influence of Backdating in Patients With Prostate Cancer Treated With 3-dimensional Conformal Radiation Therapy AloneJournal of Urology, VOL. 169, NO. 6, (2153-2159), Online publication date: 1-Jun-2003.CRITZ F (2018) Time to Achieve a Prostate Specific Antigen Nadir of 0.2 Ng./ml. After Simultaneous Irradiation For Prostate CancerJournal of Urology, VOL. 168, NO. 6, (2434-2438), Online publication date: 1-Dec-2002.Gretzer M, Trock B, Han M and Walsh P (2018) A Critical Analysis of the Interpretation of Biochemical Failure in Surgically Treated Patients Using the American Society for Therapeutic Radiation and Oncology CriteriaJournal of Urology, VOL. 168, NO. 4 Part 1, (1419-1422), Online publication date: 1-Oct-2002. Volume 167Issue 3March 2002Page: 1310-1313 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.Keywordsprostateprostate-specific antigendisease-free survivalprostatic neoplasmsMetricsAuthor Information FRANK A. CRITZ More articles by this author Expand All Advertisement PDF downloadLoading ...
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