Long-term Outcome of Prostate Cancer Patients Who Exhibit Biochemical Failure Despite Salvage Radiation Therapy After Radical Prostatectomy

Ying, James; Wang, Chiachien J.; Yan, Jingsheng; Liauw, Stanley L.; Straka, Christopher; Pistenmaa, David; Xie, Xian-Jin; Lotan, Yair; Roehrborn, Claus G.; Kim, D. Nathan

doi:10.1097/coc.0000000000000207

Cited by 11 publications

(10 citation statements)

References 33 publications

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“…Although SRT allows to achieve a satisfactory long-term overall survival (OS) of 13.6 years, a second BR may occur in 50% of patients. 6 Therefore, it is critical to identify patients undergoing SRT that necessitate additional treatments. Analysis of the efficiency of second or third line hormonal treatment for PC patients relapsed after hormone therapy, revealed the effectiveness of nonsteroidal antiandrogens as alternative therapies, particularly for second line responders, whose survival was significantly higher than nonresponders, indicating a potential predictive prognostic value for second line responsiveness and supporting the concept that second line responders, although androgen independent, are still hormonally sensitive.…”

Section: Introductionmentioning

confidence: 99%

Tumor infiltrating T lymphocytes expressing FoxP3, CCR7 or PD-1 predict the outcome of prostate cancer patients subjected to salvage radiotherapy after biochemical relapse

Nardone

Botta

Caraglia

et al. 2016

Cancer Biology & Therapy

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Tumor immunologic microenvironment is strongly involved in tumor progression and the presence of tumor infiltrating lymphocytes (TIL) with different phenotypes has been demonstrated to be of prognostic relevance in different malignancies. We investigated whether TIL infiltration of tumor tissues could also predict the outcome of prostate cancer patients. To this end, we carried out a retrospective analysis correlating the outcome of locally advanced prostate cancer patients undergone salvage radiotherapy upon relapse after radical surgery with the infiltration by different TIL populations. Twenty-two patients with resectable prostate cancer, with a mean age of 67 (C/¡3.93) years, who received salvage radiotherapy with a mean of 69.66 (C/¡ 3.178) Gy in 8 weeks, between June 1999 and January 2009 and with a median follow up of 123 (C/¡ 55.82) months, were enrolled in this study. We evaluated, by immunohistochemistry, the intratumoral ( t ) and peripheral stroma ( p ) infiltration by CD45, CD3, CD4, CD8, CCR7, FoxP3 or PD-1-positive cells on tumor samples taken at the diagnosis ( d ) and relapse times ( R ). We correlated these variables with patients' biochemical progression free survival (bPFS), post-radiotherapy progression free survival (PFS), and overall survival (OS). Substantial changes in the rate of TIL subsets were found between the first and the second biopsy with progressive increase in CD4, CCR7, FoxP3, PD-1 C cells. Our analysis revealed that higher CD8 p,RC and lower PD-1 RC TIL scores correlated to a longer bPFS. Higher CD8 p,RC and CCR7 t,RC TIL scores and lower CD45 p,RC and FoxP3 p,RC TIL scores correlated to a prolonged PFS and OS. These results suggest that the immunological microenvironment of primary tumor is strictly correlated with patient outcome and provide the rationale for immunological treatment of prostate cancer.

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Section: Introductionmentioning

confidence: 99%

Tumor infiltrating T lymphocytes expressing FoxP3, CCR7 or PD-1 predict the outcome of prostate cancer patients subjected to salvage radiotherapy after biochemical relapse

Nardone

Botta

Caraglia

et al. 2016

Cancer Biology & Therapy

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“…In one of the series with the longest followup (median 126 months), only 56% experienced BCR after salvage EBRT; OS averaged 13.6 years from the time of PSA failure. 8 Conversely, we might also interpret the present results as showing the benefit of EBRT in a majority of patients presenting with persistent or recurrent prostate cancer.…”

Section: Discussionmentioning

confidence: 45%

CAPRA-S predicts outcome for adjuvant and salvage EBRT after radical prostatectomy

Zimmermann

Delouya

Al‐Enizi

et al. 2016

CUAJ

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Introduction: We aimed to evaluate the predictive value of the Cancer of the Prostate Risk Assessment Postsurgical Score (CAPRA-S) for patients treated with radical prostatectomy followed by subsequent external beam radiotherapy (EBRT).Methods: A total of 373 patients treated with EBRT between January 2000 and June 2015 were identified in the institutional database. Followup and complete CAPRA-S score were available for 334 (89.5%) patients. CAPRA-S scores were sorted into previously defined categories of low- (score 0‒2), intermediate- (3‒5), and high-risk (6‒12). Time to biochemical recurrence (BCR) was defined as prostate-specific antigen (PSA) >0.20 ng/mL after EBRT. Survival analyses were performed using the Kaplan-Meier method and comparisons were made using the log-rank test.Results: Overall median time from surgery to EBRT was 18 months (interquartile range [IQR] 8‒36) and median followup since EBRT was 48 months (IQR 28‒78). CAPRA-S predicted time to BCR (<0.001), time to palliative androgen-deprivation therapy (ADT) (p=0.017), and a trend for significantly predicting overall survival (OS, p=0.058). On multivariate analysis, the CAPRA-S was predictive of time to BCR only (low-risk vs. intermediate-risk; hazard ratio [HR] 0.14, 95% confidence interval [CI] 0.043‒0.48, p=0.001). The last PSA measurement before EBRT as a continuous and grouped variable proved highly significant in predicting all outcomes tested, including OS (p≤0.002).Conclusions: CAPRA-S predicts time to BCR and freedom from palliative ADT, and is borderline significant for OS. Together with the PSA before EBRT, CAPRA-S is a useful, predictive tool. The main limitation of this study is its retrospective design.

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“…SV size can also play a significant role in diagnosis and treatment of prostate cancer. A recent study of markers for aggressive prostate cancer in 406 patients found that SV invasion (SVI) by localised prostate cancer is associated with a worse post-operative recurrence-free survival, a finding corroborated by other studies (Mitchell et al, 2016;Troyer et al, 2015;Ying et al, 2015). However, while MRI is reliable in detecting extracapsular extension of prostate cancer, it remains suboptimal at detecting SVI.…”

Section: Discussionmentioning

confidence: 74%

The association between seminal vesicle size and duration of abstinence from ejaculation

et al. 2016

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There are few data describing the relationship between seminal vesicle (SV) size and duration of abstinence between ejaculations. This study evaluates the association between SV size and duration of abstinence from ejaculation using pelvic magnetic resonance imaging(MRI).Sexually active men 18–68 years old who underwent pelvic MRI for various medical indications were included. The date of last ejaculation was recorded, and the cross-sectional areas of the right and left seminal vesicles were calculated separately using mediolateral and anteroposterior measurements on T2 weighted MRI images. The association between SV area and duration of abstinence between ejaculations was determined via linear regression analysis. The study cohort consisted of 104 men with a mean age of 46.45±11.4 (range 18–68)years old. Mean right and left SV cross-sectional areas were 744.1±351.1 (range: 149.9–1794.7) mm2 and 727.6±359.2 (range 171.4 to 2248.4) mm2, respectively. The mean duration of abstinence between ejaculations in the cohort was 3.6±2.6 (range 1–15) days. Although no correlation between age and SV area was observed (r=0.007, p = 0.947),linear regression analysis demonstrated a positive correlation between SV area and the duration of abstinence from ejaculation(r=0.372, p=0.0001).SV cross-sectional area increases with duration of abstinence from ejaculation and can be assessed using MRI. The use of SV size estimation may be applicable in diagnosis, risk stratification, and treatment of urological diseases.

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Long-term Outcome of Prostate Cancer Patients Who Exhibit Biochemical Failure Despite Salvage Radiation Therapy After Radical Prostatectomy

Cited by 11 publications

References 33 publications

Tumor infiltrating T lymphocytes expressing FoxP3, CCR7 or PD-1 predict the outcome of prostate cancer patients subjected to salvage radiotherapy after biochemical relapse

Tumor infiltrating T lymphocytes expressing FoxP3, CCR7 or PD-1 predict the outcome of prostate cancer patients subjected to salvage radiotherapy after biochemical relapse

CAPRA-S predicts outcome for adjuvant and salvage EBRT after radical prostatectomy

The association between seminal vesicle size and duration of abstinence from ejaculation

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