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Long-term oncologic results of salvage radical prostatectomy for locally recurrent prostate cancer after radiotherapy.
Int J Radiat Oncol Biol Phys. 2005 Jun 01; 62(2):448-53.IJ

Abstract

PURPOSE

Salvage radical prostatectomy (RP) may potentially cure patients who have isolated local prostate cancer recurrence after radiotherapy (RT). We report the long-term cancer control associated with salvage RP in a consecutive cohort of patients and identify the variables associated with disease progression and cancer survival.

METHODS AND MATERIALS

A total of 100 consecutive patients underwent salvage RP with curative intent for biopsy-confirmed, locally recurrent, prostate cancer after RT. Disease progression after salvage RP was defined as a prostate-specific antigen (PSA) level of > or =0.2 ng/mL or by initiation of androgen deprivation therapy. Cancer-specific mortality was defined as active clinical disease progression despite castration. Cox regression analysis was used to evaluate these endpoints. The median follow-up from RT was 10 years (range, 3-27 years) and from salvage RP was 5 years (range, 1-20 years).

RESULTS

Overall, the 5-year progression-free probability was 55% (95% confidence interval, 46-64%), and the median progression-free interval was 6.4 years. The preoperative PSA level was the only significant pretreatment predictor of disease progression in the multivariate analysis (p = 0.01). The 5-year progression-free probability for patients with a preoperative PSA level of <4, 4-10, and >10 ng/mL was 86%, 55%, and 37%, respectively. The 10-year and 15-year cancer-specific mortality after salvage RP was 27% and 40%, respectively. The median time from disease progression to cancer-specific death was 10.3 years (95% confidence interval, 7.6-12.9). After multivariate analysis, the preoperative serum PSA level and seminal vesicle or lymph node status correlated independently with disease progression.

CONCLUSIONS

Greater preoperative PSA levels are associated with disease progression and cancer-specific death. Long-term control of locally recurrent prostate cancer after definitive RT is possible when salvage RP is performed early in the course of recurrent disease.

Authors+Show Affiliations

Department of Urology, Sidney Kimmel Center for Prostate and Urologic Cancers, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15890586

Citation

Bianco, Fernando J., et al. "Long-term Oncologic Results of Salvage Radical Prostatectomy for Locally Recurrent Prostate Cancer After Radiotherapy." International Journal of Radiation Oncology, Biology, Physics, vol. 62, no. 2, 2005, pp. 448-53.
Bianco FJ, Scardino PT, Stephenson AJ, et al. Long-term oncologic results of salvage radical prostatectomy for locally recurrent prostate cancer after radiotherapy. Int J Radiat Oncol Biol Phys. 2005;62(2):448-53.
Bianco, F. J., Scardino, P. T., Stephenson, A. J., Diblasio, C. J., Fearn, P. A., & Eastham, J. A. (2005). Long-term oncologic results of salvage radical prostatectomy for locally recurrent prostate cancer after radiotherapy. International Journal of Radiation Oncology, Biology, Physics, 62(2), 448-53.
Bianco FJ, et al. Long-term Oncologic Results of Salvage Radical Prostatectomy for Locally Recurrent Prostate Cancer After Radiotherapy. Int J Radiat Oncol Biol Phys. 2005 Jun 1;62(2):448-53. PubMed PMID: 15890586.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term oncologic results of salvage radical prostatectomy for locally recurrent prostate cancer after radiotherapy. AU - Bianco,Fernando J,Jr AU - Scardino,Peter T, AU - Stephenson,Andrew J, AU - Diblasio,Christopher J, AU - Fearn,Paul A, AU - Eastham,James A, PY - 2004/06/23/received PY - 2004/09/17/revised PY - 2004/09/30/accepted PY - 2005/5/14/pubmed PY - 2005/6/28/medline PY - 2005/5/14/entrez SP - 448 EP - 53 JF - International journal of radiation oncology, biology, physics JO - Int. J. Radiat. Oncol. Biol. Phys. VL - 62 IS - 2 N2 - PURPOSE: Salvage radical prostatectomy (RP) may potentially cure patients who have isolated local prostate cancer recurrence after radiotherapy (RT). We report the long-term cancer control associated with salvage RP in a consecutive cohort of patients and identify the variables associated with disease progression and cancer survival. METHODS AND MATERIALS: A total of 100 consecutive patients underwent salvage RP with curative intent for biopsy-confirmed, locally recurrent, prostate cancer after RT. Disease progression after salvage RP was defined as a prostate-specific antigen (PSA) level of > or =0.2 ng/mL or by initiation of androgen deprivation therapy. Cancer-specific mortality was defined as active clinical disease progression despite castration. Cox regression analysis was used to evaluate these endpoints. The median follow-up from RT was 10 years (range, 3-27 years) and from salvage RP was 5 years (range, 1-20 years). RESULTS: Overall, the 5-year progression-free probability was 55% (95% confidence interval, 46-64%), and the median progression-free interval was 6.4 years. The preoperative PSA level was the only significant pretreatment predictor of disease progression in the multivariate analysis (p = 0.01). The 5-year progression-free probability for patients with a preoperative PSA level of <4, 4-10, and >10 ng/mL was 86%, 55%, and 37%, respectively. The 10-year and 15-year cancer-specific mortality after salvage RP was 27% and 40%, respectively. The median time from disease progression to cancer-specific death was 10.3 years (95% confidence interval, 7.6-12.9). After multivariate analysis, the preoperative serum PSA level and seminal vesicle or lymph node status correlated independently with disease progression. CONCLUSIONS: Greater preoperative PSA levels are associated with disease progression and cancer-specific death. Long-term control of locally recurrent prostate cancer after definitive RT is possible when salvage RP is performed early in the course of recurrent disease. SN - 0360-3016 UR - https://www.unboundmedicine.com/medline/citation/15890586/Long_term_oncologic_results_of_salvage_radical_prostatectomy_for_locally_recurrent_prostate_cancer_after_radiotherapy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0360-3016(04)02699-9 DB - PRIME DP - Unbound Medicine ER -