Survival analysis of patients with biochemical relapse after radical prostatectomy treated with androgen deprivation: Castration-resistance influential factors

Algarra, R.; Hevia, M.; Tienza, Antonio; Merino, I.; Velis, J.M.; Zudaire, Javier; Robles, J.E.; Pascual, Ignacio

doi:10.5489/cuaj.1665

Cited by 7 publications

(4 citation statements)

References 40 publications

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“…In our study, PSAV, PSADT, and Gleason score were not independently associated with survival endpoints. On the other hand, several studies have recommended that these parameters be utilized to decide on the timing of ADT at PSA-recurrence following RP [19][20][21][22][23][24][25][26][27][28][29]. Van den Bergh, et al reported in a systematic review that early ADT cannot be recommended as the standard-of-care in the setting of PSA recurrence or local recurrence, and that ADT should be reserved for patients with the highest risk of disease progression, defined as short PSADT of less than 6-12 months or Gleason score of greater than 8 [21].…”

Section: Discussionmentioning

confidence: 99%

“…Van den Bergh, et al reported in a systematic review that early ADT cannot be recommended as the standard-of-care in the setting of PSA recurrence or local recurrence, and that ADT should be reserved for patients with the highest risk of disease progression, defined as short PSADT of less than 6-12 months or Gleason score of greater than 8 [21]. Algarra, et al reported seminal vesical involvement and PSAV of greater than 0.84 ng/mL/year, in addition to PSADT, to be adverse features associated with disease progression in patients who received ADT at PSA recurrence [22]. In a cohort of patients with mainly high-risk disease, faster PSADT, higher Gleason score, and early intervention were associated with a lower risk of CSS [25].…”

Section: Discussionmentioning

confidence: 99%

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Impact of early versus delayed androgen-deprivation therapy on survival outcomes of patients with localized prostate cancer who underwent radical prostatectomy and later developed metastasis: Can we define a PSA threshold?

Ahn

Lee

Kim

et al. 2020

Preprint

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Background: The benefits of early administration of androgen-deprivation therapy (ADT) in patients with prostate-specific antigen (PSA)-only recurrent prostate cancer (PCa) following radical prostatectomy (RP) are controversial. We investigated the impact of early versus delayed ADT on survival outcomes in patients with non-metastatic, localized or locally advanced PCa who received radiation therapy following RP and later developed distant metastasis.Methods: A retrospective analysis was performed on 69 patients with non-metastatic, localized or locally advanced PCa who received radiation therapy following RP and later developed distant metastasis between January 2006 and December 2012. Patients were stratified according to the level of PSA at which ADT was administered (<2 ng/mL vs. ≥2 ng/mL). Study endpoints were progression to castration-resistant prostate cancer (CRPC)-free survival and cancer-specific survival (CSS) assessed by Kaplan-Meier analysis and Cox-regression models.Results: Patients were stratified according to the level of PSA at which ADT was administered (<2 ng/mL vs. ≥2 ng/mL) based on the Youden sensitivity analysis. Delayed ADT at PSA ≥2 ng/mL was an independent prognosticator of cancer-specific mortality (p=0.047), and a marginally significant prognosticator of progression to CRPC (p=0.051). During the median follow-up of 81.0 (IQR 54.2-115.7) months, patients who received early ADT at PSA <2 ng/mL had significantly higher CSS rates than patients who received delayed ADT at PSA ≥2 ng/mL (p=0.002). Progression to CRPC-free survival was comparable between the two groups (p=0.331).Conclusions: Early ADT at the PSA level of less than 2 ng/mL confers CSS benefits in patients with localized or locally advanced PCa previously treated with RP.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Impact of early versus delayed androgen-deprivation therapy on survival outcomes of patients with localized prostate cancer who underwent radical prostatectomy and later developed metastasis: Can we define a PSA threshold?

Ahn

Lee

Kim

et al. 2020

Preprint

View full text Add to dashboard Cite

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“… 20 21 22 23 25 26 27 28 29 30 Van den Bergh, et al 22 reported in a systematic review that early ADT cannot be recommended as the standard-of-care for PSA recurrence or local recurrence, and that ADT should be reserved for patients with the highest risk of disease progression, defined as short PSADT of less than 6–12 months or Gleason score of greater than 8. Algarra, et al 23 reported seminal vesical involvement, PSAV of greater than 0.84 ng/mL/year, and PSADT to be considered as adverse features associated with disease progression in patients who received ADT at PSA recurrence. In a cohort of patients with mainly high-risk disease, faster PSADT, higher Gleason score, and early intervention were associated with a lower risk of CSS.…”

Section: Discussionmentioning

confidence: 99%

Optimal PSA Threshold for Androgen-Deprivation Therapy in Patients with Prostate Cancer following Radical Prostatectomy and Adjuvant Radiation Therapy

et al. 2020

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The benefits of early administration of androgen-deprivation therapy (ADT) in patients with prostate-specific antigen (PSA)-only recurrent prostate cancer (PCa) following radical prostatectomy (RP) are controversial. We investigated the impact of early versus delayed ADT on survival outcomes in patients with non-metastatic, localized or locally advanced PCa who received radiation therapy (RT) following RP and later developed distant metastasis. Materials and Methods: A retrospective analysis was performed on 69 patients with non-metastatic, localized or locally advanced PCa who received RT following RP and later developed distant metastasis between January 2006 and December 2012. Patients were stratified according to the level of PSA at which ADT was administered (<2 ng/mL vs. ≥2 ng/mL). Study endpoints were progression to castration-resistant prostate cancer (CRPC)-free survival and cancer-specific survival (CSS). Results: Patients were stratified according to the criteria of 2 ng/mL of PSA at which ADT was administered, based on the Youden sensitivity analysis. Delayed ADT at PSA ≥2 ng/mL was an independent prognosticator of cancer-specific mortality (p=0.047), and a marginally significant prognosticator of progression to CRPC (p=0.051). During the median follow-up of 81.0 (interquartile range 54.2-115.7) months, patients who received early ADT at PSA <2 ng/mL had significantly higher CSS rates compared to patients who received delayed ADT at PSA ≥2 ng/mL (p=0.002). Progression to CRPC-free survival was comparable between the two groups (p=0.331). Conclusion: Early ADT at the PSA level of less than 2 ng/mL confers CSS benefits in patients with localized or locally advanced PCa who were previously treated with RP.

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“…Prostate cancer (PCa) is one of the most prevalent cancer types in men; in 2015, there were 60,300 newly diagnosed cases of PCa in China, resulting in 26,000 mortalities ( 1 ). Disease recurrence has been reported in a large proportion of patients following radical prostatectomy ( 2 ), and castration-resistant disease typically develops as a result ( 3 , 4 ). Although prognostic and clinical indicators were implemented, the prognostic effect was not fully understood ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

Identification of genes that predict the biochemical recurrence of prostate cancer

Chu

Gai

2018

Oncol Lett

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Prostate cancer (PCa) is one of the most prevalent cancer types in men. Biochemical recurrence continues to occur in a large proportion of patients after radical prostatectomy. Thus, prognostic biomarkers are required to determine which treatment is suitable. In the present study, RNA-sequencing gene expression data from The Cancer Genome Atlas was used in order to develop a risk-score staging system based on the expression of eight genes. Cox multivariate regression was used to predict the outcome of patients with PCa. The biomedical recurrence-free survival of patients with low-risk scores was significantly longer compared with patients with high-risk scores (P=5×10−7). This result was further validated using another dataset, GSE70769, from the National Center for Biotechnology Information. The prognostic values of other clinical information and risk scores were evaluated for 5-year biochemical recurrence. The prognostic value of the risk score was determined using an area under curve value of 0.819, predicting the 5-year biochemical recurrence of patients with PCa. The risk score was identified to be significantly associated with primary tumor stage (P<0.01), Gleason score (P<0.01), and lymph node invasion (P<0.05), but was independent of age. Cox multivariate regression revealed that the risk score was an indicator for prediction of biochemical recurrence. Thus, the risk score is a valuable and robust indicator for predicting the biochemical recurrence of patients with PCa.

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Survival analysis of patients with biochemical relapse after radical prostatectomy treated with androgen deprivation: Castration-resistance influential factors

Abstract: In BCR patients treated with ADT, the median to CR was 14 years. PSA-DT <6 months, PSA velocity (ng/mL/year) and seminal vesicle involvement were influential variables. From the CR, the median time to death was 3.2 years. Ki-67 marker was an independent influence.

Cited by 7 publications

References 40 publications

Impact of early versus delayed androgen-deprivation therapy on survival outcomes of patients with localized prostate cancer who underwent radical prostatectomy and later developed metastasis: Can we define a PSA threshold?

Impact of early versus delayed androgen-deprivation therapy on survival outcomes of patients with localized prostate cancer who underwent radical prostatectomy and later developed metastasis: Can we define a PSA threshold?

Optimal PSA Threshold for Androgen-Deprivation Therapy in Patients with Prostate Cancer following Radical Prostatectomy and Adjuvant Radiation Therapy

Identification of genes that predict the biochemical recurrence of prostate cancer

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