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The impact of adjuvant therapy in patients with biochemical recurrence on prostate cancer progression and mortality five years after radical prostatectomy.

Fryczkowski M, Bryniarski P, Szczębara M, Suchodolski M, Paradysz A - Cent European J Urol (2011)

Bottom Line: Five-year general and disease-specific survival was evaluated and choice prognostic factors were compared.The risk of BCR 5-years after RP is greater in patients with high initial concentration of PSA, higher Gleason score, and clinical advancement.Five-year overall and disease-specific survivals are higher among patients after hormonotherapy alone compared to those after both radio- and hormonotherapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Medical University of Silesia in Katowice, Zabrze, Poland.

ABSTRACT

Introduction: The clinical significance of biochemical recurrence (BCR) after radical prostatectomy (RP) due to prostate cancer (PCa) is not unambiguous, sometimes being independent from the real progression. BCR is followed by a greater risk of adverse events and almost always results with the necessity for implementation of adjuvant therapy (AT). The aim of the following study was to examine the impact of AT in patients with BCR together with PCa progression and mortality 5-years after RP.

Material and methods: Two hundred forty-seven patients after RP, who were treated in the period from 1995 to 2009, underwent the retrospective analysis. They were divided into three groups according to the applied AT after prior BCR diagnosis. The first group (n - 39) included patients treated with radiotherapy, along with hormonotherapy. The second group (n - 63) covers patients receiving hormonotherapy only. The third group (n - 145) consists of patients without BCR. Five-year general and disease-specific survival was evaluated and choice prognostic factors were compared.

Results: Five-year overall survival was 74.2% in group I, 88.3% in group II, and 98.7% in group III. Diseasespecific survival was: 76.9%, 90.5%, and 100% (p = 0.001), respectively. BCR was diagnosed in 102 (41.5%) patients; while in another 24 (23.5%) of them progression was diagnosed after the AT was applied.

Conclusions: The risk of BCR 5-years after RP is greater in patients with high initial concentration of PSA, higher Gleason score, and clinical advancement. Five-year overall and disease-specific survivals are higher among patients after hormonotherapy alone compared to those after both radio- and hormonotherapy.

No MeSH data available.


Related in: MedlinePlus

Clinical advancement of PCa in patients depending on cancer progression.
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Figure 0002: Clinical advancement of PCa in patients depending on cancer progression.

Mentions: The results showed no differences in tPSA concentrations among the compared groups of patients (p = 0.38). Also, among the patients in the first two groups, differences in Gleason score (Gs) were not statistically significant and neither were the time to progression (p = 0.48) nor the local recurrence rate (p = 0.059). While the proportion of metastases (p = 0.01) as well as deaths (p = 0.001) differed significantly. The clinical progression of PCa showed significant statistical difference between patients with pT1 for the benefit of the third group and pT3-4 for the benefit of the first two groups (p = 0.001) (Fig. 1). The highest progression was observed among patients with pT3-4 (p <0.001) (Fig. 2). Both groups of patients with BCR showed a similar rate of each stage of clinical progression. The influence of time of recurrence on progression rate did not show a significant difference between patients from the first and second group (Table 2). A statistically significant difference was shown in the percentage of BCR with respect to the time of their diagnosis in each of the two groups separately (p = 0.001).


The impact of adjuvant therapy in patients with biochemical recurrence on prostate cancer progression and mortality five years after radical prostatectomy.

Fryczkowski M, Bryniarski P, Szczębara M, Suchodolski M, Paradysz A - Cent European J Urol (2011)

Clinical advancement of PCa in patients depending on cancer progression.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3921737&req=5

Figure 0002: Clinical advancement of PCa in patients depending on cancer progression.
Mentions: The results showed no differences in tPSA concentrations among the compared groups of patients (p = 0.38). Also, among the patients in the first two groups, differences in Gleason score (Gs) were not statistically significant and neither were the time to progression (p = 0.48) nor the local recurrence rate (p = 0.059). While the proportion of metastases (p = 0.01) as well as deaths (p = 0.001) differed significantly. The clinical progression of PCa showed significant statistical difference between patients with pT1 for the benefit of the third group and pT3-4 for the benefit of the first two groups (p = 0.001) (Fig. 1). The highest progression was observed among patients with pT3-4 (p <0.001) (Fig. 2). Both groups of patients with BCR showed a similar rate of each stage of clinical progression. The influence of time of recurrence on progression rate did not show a significant difference between patients from the first and second group (Table 2). A statistically significant difference was shown in the percentage of BCR with respect to the time of their diagnosis in each of the two groups separately (p = 0.001).

Bottom Line: Five-year general and disease-specific survival was evaluated and choice prognostic factors were compared.The risk of BCR 5-years after RP is greater in patients with high initial concentration of PSA, higher Gleason score, and clinical advancement.Five-year overall and disease-specific survivals are higher among patients after hormonotherapy alone compared to those after both radio- and hormonotherapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Medical University of Silesia in Katowice, Zabrze, Poland.

ABSTRACT

Introduction: The clinical significance of biochemical recurrence (BCR) after radical prostatectomy (RP) due to prostate cancer (PCa) is not unambiguous, sometimes being independent from the real progression. BCR is followed by a greater risk of adverse events and almost always results with the necessity for implementation of adjuvant therapy (AT). The aim of the following study was to examine the impact of AT in patients with BCR together with PCa progression and mortality 5-years after RP.

Material and methods: Two hundred forty-seven patients after RP, who were treated in the period from 1995 to 2009, underwent the retrospective analysis. They were divided into three groups according to the applied AT after prior BCR diagnosis. The first group (n - 39) included patients treated with radiotherapy, along with hormonotherapy. The second group (n - 63) covers patients receiving hormonotherapy only. The third group (n - 145) consists of patients without BCR. Five-year general and disease-specific survival was evaluated and choice prognostic factors were compared.

Results: Five-year overall survival was 74.2% in group I, 88.3% in group II, and 98.7% in group III. Diseasespecific survival was: 76.9%, 90.5%, and 100% (p = 0.001), respectively. BCR was diagnosed in 102 (41.5%) patients; while in another 24 (23.5%) of them progression was diagnosed after the AT was applied.

Conclusions: The risk of BCR 5-years after RP is greater in patients with high initial concentration of PSA, higher Gleason score, and clinical advancement. Five-year overall and disease-specific survivals are higher among patients after hormonotherapy alone compared to those after both radio- and hormonotherapy.

No MeSH data available.


Related in: MedlinePlus