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Risk-adjusted hazard rates of biochemical recurrence for prostate cancer patients after radical prostatectomy.
Eur Urol. 2009 Feb; 55(2):412-19.EU

Abstract

BACKGROUND

Current prostate cancer (PCa) follow-up guidelines do not account for the risk of disease relapse.

OBJECTIVE

To examine the annual hazard rate (anHR) of biochemical recurrence (BCR) according to risk strata in patients treated with radical prostatectomy (RP) for localised PCa. These rates might be used to devise a risk-adjusted follow-up.

DESIGN, SETTING, AND PARTICIPANTS

From January 1992 to December 2005, 2911 patients underwent RP for localised PCa in one institution. This cohort was used to identify three distinct risk groups for BCR. A cohort of 2875 patients operated on in a second institution was used for validation purpose.

INTERVENTION

RP, prostate-specific antigen (PSA) tests.

MEASUREMENTS

Cox regression models addressing BCR were used to identify significant predictors and cut-offs for risk group stratification. The anHR for BCR was calculated (number of events divided by number of patients at risk) for each risk group.

RESULTS AND LIMITATIONS

Three risk groups could be identified: (1) low risk (23.7%), defined as PSA <11ng/ml plus clinical stage T1c plus pathological Gleason <6 plus negative surgical margins plus organ confined tumour; (2) high risk (18.9%), defined as PSA >22ng/ml or seminal vesicle invasion or pathological Gleason sum >8 or lymph node invasion or clinical stage T3; and (3) intermediate risk (57.4%), defined as all other patients. The anHR for the low-risk groups remained very low throughout follow-up (0-2.6). The anHR in the intermediate-risk group was initially low but remained elevated (1.3-7.2). The anHR for the high-risk group was initially markedly high (up to 32) and remained elevated during follow-up.

CONCLUSIONS

Annual hazard rates of BCR differ according to risk strata. These data might be used to devise a risk-adjusted follow-up protocol. Low-risk patients appear to need less frequent follow-up, whereas high-risk patients might need to be followed more frequently, relative to the current recommendations.

Authors+Show Affiliations

Cancer Prognostics and Health Outcomes Unit, University of Montreal, Montreal, Quebec, Canada. walzj@marseille.fnclcc.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

19027223

Citation

Walz, Jochen, et al. "Risk-adjusted Hazard Rates of Biochemical Recurrence for Prostate Cancer Patients After Radical Prostatectomy." European Urology, vol. 55, no. 2, 2009, pp. 412-19.
Walz J, Chun FK, Klein EA, et al. Risk-adjusted hazard rates of biochemical recurrence for prostate cancer patients after radical prostatectomy. Eur Urol. 2009;55(2):412-19.
Walz, J., Chun, F. K., Klein, E. A., Reuther, A., Graefen, M., Huland, H., & Karakiewicz, P. I. (2009). Risk-adjusted hazard rates of biochemical recurrence for prostate cancer patients after radical prostatectomy. European Urology, 55(2), 412-19. https://doi.org/10.1016/j.eururo.2008.11.005
Walz J, et al. Risk-adjusted Hazard Rates of Biochemical Recurrence for Prostate Cancer Patients After Radical Prostatectomy. Eur Urol. 2009;55(2):412-19. PubMed PMID: 19027223.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk-adjusted hazard rates of biochemical recurrence for prostate cancer patients after radical prostatectomy. AU - Walz,Jochen, AU - Chun,Felix K H, AU - Klein,Eric A, AU - Reuther,Alwyn, AU - Graefen,Markus, AU - Huland,Hartwig, AU - Karakiewicz,Pierre I, Y1 - 2008/11/21/ PY - 2008/06/29/received PY - 2008/11/07/accepted PY - 2008/11/26/pubmed PY - 2009/9/26/medline PY - 2008/11/26/entrez SP - 412 EP - 19 JF - European urology JO - Eur Urol VL - 55 IS - 2 N2 - BACKGROUND: Current prostate cancer (PCa) follow-up guidelines do not account for the risk of disease relapse. OBJECTIVE: To examine the annual hazard rate (anHR) of biochemical recurrence (BCR) according to risk strata in patients treated with radical prostatectomy (RP) for localised PCa. These rates might be used to devise a risk-adjusted follow-up. DESIGN, SETTING, AND PARTICIPANTS: From January 1992 to December 2005, 2911 patients underwent RP for localised PCa in one institution. This cohort was used to identify three distinct risk groups for BCR. A cohort of 2875 patients operated on in a second institution was used for validation purpose. INTERVENTION: RP, prostate-specific antigen (PSA) tests. MEASUREMENTS: Cox regression models addressing BCR were used to identify significant predictors and cut-offs for risk group stratification. The anHR for BCR was calculated (number of events divided by number of patients at risk) for each risk group. RESULTS AND LIMITATIONS: Three risk groups could be identified: (1) low risk (23.7%), defined as PSA <11ng/ml plus clinical stage T1c plus pathological Gleason <6 plus negative surgical margins plus organ confined tumour; (2) high risk (18.9%), defined as PSA >22ng/ml or seminal vesicle invasion or pathological Gleason sum >8 or lymph node invasion or clinical stage T3; and (3) intermediate risk (57.4%), defined as all other patients. The anHR for the low-risk groups remained very low throughout follow-up (0-2.6). The anHR in the intermediate-risk group was initially low but remained elevated (1.3-7.2). The anHR for the high-risk group was initially markedly high (up to 32) and remained elevated during follow-up. CONCLUSIONS: Annual hazard rates of BCR differ according to risk strata. These data might be used to devise a risk-adjusted follow-up protocol. Low-risk patients appear to need less frequent follow-up, whereas high-risk patients might need to be followed more frequently, relative to the current recommendations. SN - 1873-7560 UR - https://www.unboundmedicine.com/medline/citation/19027223/Risk_adjusted_hazard_rates_of_biochemical_recurrence_for_prostate_cancer_patients_after_radical_prostatectomy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0302-2838(08)01312-2 DB - PRIME DP - Unbound Medicine ER -