Preoperative serum prostate-specific antigen and gleason grade as predictors of pathologic stage in clinically organ confined prostate cancer: Implications for the choice of primary treatment

Ennis, Ronald D.; Flynn, Stuart D.; Fischer, Dennis; Peschel, Richard E.

doi:10.1016/0360-3016(94)90010-8

Cited by 16 publications

(5 citation statements)

References 41 publications

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“…Petrovich et al [19] also reported very significant adverse effects on the bNED outcome using postoperative RT for both positive seminal vesicle involvement and preoperative PSA > 25. Our study did not find that Gleason score was a significant predictor of biochemical failure following RT although other studies have found a Gleason score >7 to have an adverse effect on bNED survival [5, 7, 19].…”

Section: Discussioncontrasting

confidence: 95%

“…Unfortunately, a surprisingly high fraction of patients with clinically localized prostate cancer are not cured following surgery. For example, 30%–40% of early prostate cancer patients with an initial prostate specific antigen (PSA) < 10 and 70%–80% of patients with a PSA > 10 or Gleason score 8%–10 will be pathologically upstaged following RP [2]. These patients are at high risk for subsequent biochemical and clinical recurrence.…”

Section: Introductionmentioning

confidence: 99%

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PSA based review of adjuvant and salvage radiation therapy vs. observation in postoperative prostate cancer patients

et al. 2000

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Because of the uncertainties regarding the efficacy of postoperative radiation therapy for early prostate cancer, treatment strategies following radical prostatectomy include: (1) observation alone in high‐risk patients, (2) adjuvant radiation therapy (PSA undetectable) in high‐risk patients, or (3) salvage radiation therapy for biochemical and clinical recurrence. Fifty‐two patients treated with postoperative radiation therapy in either an adjuvant setting (13) or for salvage (39) were retrospectively reviewed. The actuarial biochemical disease‐free survival (bNED) rates following radiation therapy were calculated using the life‐table method. Univariate and multi variate analyses were used to define the clinical factors that predict biochemical failure following postoperative radiation therapy. In addition, the bNED survival rate for 36 high‐risk surgery patients who were simply observed following prostatectomy was determined. The 3‐year bNED survival rate for the adjuvant radiation group was 85% compared with 27% for salvage radiation and 43% for the observation group. These results are statistically significant. Factors that predict biochemical failure following postoperative radiation therapy include preoperative PSA level, pre‐radiation therapy PSA level, and seminal vesicle involvement. At our institutions, adjuvant radiation therapy was a superior strategy compared with either observation alone or salvage radiation therapy for high‐risk postoperative prostate cancer patients. Int. J. Cancer (Radiat. Oncol. Invest.) 90, 29–36 (2000). © 2000 Wiley‐Liss, Inc.

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Section: Discussioncontrasting

confidence: 95%

Section: Introductionmentioning

confidence: 99%

PSA based review of adjuvant and salvage radiation therapy vs. observation in postoperative prostate cancer patients

et al. 2000

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“…La elevación del PSA después de la normalización tras el tratamiento se correlaciona con la incidencia de fracaso y con la supervivencia 7 .…”

Section: El Estadio Tumoral (Tnm) Nivel De Psa Pretratamiento Diferunclassified

Prognostic factors in urological tumours

Dueñas

Arias²,

Arcos³

et al. 2009

An Sist Sanit Navar

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Urological tumours are a heterogeneous group of neoplasms developed from the urinary tract. They include tumours of the prostate, bladder and kidney. Their incidence is high, especially amongst males, and they have different clinical courses, prognoses and treatments. This article reviews the most important prognostic factors for predicting the evolution of the neoplasm and its possibility of cure.

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“…Additional factors such as tumor ploidy and perineural invasion (PNI) also have been shown to be predictive of outcome after radiation therapy 5, 6. Patients with one or more factors that predict a high risk of recurrence after radiation therapy may be offered more aggressive treatment such as dose escalation, increased field size, or adjuvant androgen deprivation in an attempt to improve outcome 7‐10…”

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confidence: 99%

Histopathologic review of prostate biopsies from patients referred to a comprehensive cancer center

Wurzer

Al‐Saleem

Hanlon

et al. 1998

Cancer

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BACKGROUND Clinicians at the Fox Chase Cancer Center (FCCC) base prostate carcinoma treatment decisions regarding need to treat, field size, total dose, and adjuvant hormonal therapy on known prognostic factors including clinical stage, Gleason score (GS), perineural invasion (PNI), and pretreatment prostate specific antigen levels. The pathology of every patient is reviewed at FCCC to confirm a diagnosis of malignancy. The objective of this study was to define differences between pathologic reviews and their impact on treatment between outside institutions and FCCC. METHODS The authors reviewed 538 pathology reports of prostate biopsies performed at both outside pathology departments and FCCC on patients evaluated between January 1993 and December 1996. The outside pathology reviews represented 107 community hospitals, academic institutions, and private pathology laboratories. Patients who had received hormonal therapy, cryosurgery, or radical prostatectomy prior to prostate biopsy were excluded from analysis. Final FCCC pathology determinations were compared with pathology reports from outside institutions. Reports then were analyzed to determine whether differences in interpretation would have resulted in different treatment strategies. Differences in percentages according to institutional type were evaluated using the chi‐square statistic. The cost was assessed and cost per change in treatment estimated. RESULTS The 538 pathology reviews identified a nearly 40% change in GS and a 13% change in ≥2 GS between the FCCC pathology review and 107 outside academic institutions. The results of this study showed that 22% of community hospitals, 10% of private laboratories, and 8% of academic institutions demonstrated at least 2 GS changes compared with the FCCC pathology review (p = 0.001). There was no significant difference observed between types of institutions in the incidence of PNI. CONCLUSIONS This analysis provides evidence of a significant difference in the pathologic reviews of prostate biopsies conducted at FCCC and outside pathology departments. There was a nearly 40% change in GS and a 13% change in ≥2 GS between the FCCC pathology review and 107 outside institutions. The second pathology review added approximately $104 per case for a total of $55,952 to review all 538 cases. Overall, the savings in health care dollars resulting from the second pathologic review totaled $12,997. This second review of outside pathology in prostate cancer appears to be justified based on the treatment changes and on cost. Cancer 1998;83:753‐759. © 1998 American Cancer Society.

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Preoperative serum prostate-specific antigen and gleason grade as predictors of pathologic stage in clinically organ confined prostate cancer: Implications for the choice of primary treatment

Cited by 16 publications

References 41 publications

PSA based review of adjuvant and salvage radiation therapy vs. observation in postoperative prostate cancer patients

PSA based review of adjuvant and salvage radiation therapy vs. observation in postoperative prostate cancer patients

Prognostic factors in urological tumours

Histopathologic review of prostate biopsies from patients referred to a comprehensive cancer center

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