To evaluate the outcomes of prostate cancer patients with high-risk disease stratified by Gleason Score (GS) (GS ≤8 vs GS ≥9) treated with external beam radiotherapy (EBRT).
The medical records of patients who underwent EBRT between 2003 and 2011 and had nonmetastatic high-risk disease were analyzed retrospectively. Patients were treated with EBRT and all patients received a dose ≥7,560 cGy. Androgen deprivation therapy was given in most patients (90%).
A total of 155 patients were identified (GS ≤8 n = 104, GS ≥9 n = 51), and they had a median presenting prostate-specific antigen (PSA) of 14.7 ng/mL. At a median follow-up of 69 months, the 7-year biochemical failure-free survival was 59.1% in those with GS ≥9 and 69.2% in those with GS ≤8 (p = 0.12). On MVA, Gleason 9-10 (HR 1.83, p = 0.08) was not associated with an increased risk of biochemical recurrence, while a PSA >20 ng/mL (HR 2.39, p = 0.04) was associated with an increased likelihood of biochemical recurrence. Patients with GS ≥9 were noted to have worse 7-year distant metastatic-free survival (79.6% vs 90.5% p = 0.02) and cancer-specific survival (88.5% vs 97.9%, p = 0.006). On MVA, GS ≥9 was a significant indicator of distant metastatic failure and cancer-related death. Seven-year overall survival rates remained similar between the groups.
In this high-risk cohort, patients with GS 9-10 had significantly worse prostate cancer-related outcomes than other high-risk patients, suggesting that this group may warrant more aggressive treatment modalities than their high-risk counterparts.
Tumori 2016; 102(2): 168 - 173
Article Type: ORIGINAL RESEARCH ARTICLE
AuthorsJoseph J. Safdieh, David Schwartz, Joseph P. Weiner, Emmanuel Nwokedi, David Schreiber
- • Accepted on 20/01/2016
- • Available online on 19/02/2016
- • Published in print on 18/04/2016
This article is available as full text PDF.
- Safdieh, Joseph J. [PubMed] [Google Scholar] 1, 2, * Corresponding Author (Joseph.Safdieh@downstate.edu)
- Schwartz, David [PubMed] [Google Scholar] 1, 2
- Weiner, Joseph P. [PubMed] [Google Scholar] 1, 2
- Nwokedi, Emmanuel [PubMed] [Google Scholar] 2, 3
- Schreiber, David [PubMed] [Google Scholar] 1, 2
Department of Veterans Affairs, NY Harbor Campus, Brooklyn, NY - USA
SUNY Downstate Medical Center, Brooklyn, NY - USA
Kings County Medical Center, Brooklyn, NY - USA