A Model for High-Quality Community-Based Brachytherapy for Cervical Cancer: Quality Metrics and Early Outcomes

Abstract

We identified 296 patients with T1/T2 N0 prostate adenocarcinoma who underwent RP. Median age was 60 years with a median followup of 2.3 years. A total of 59% (nZ177) of patients had Gleason 7 disease and 54% (nZ154) had T1 disease. In addition, 40.8% (nZ121) of patients had biochemical failure following RP. After adjusting for clinical covariates, 4 genes were associated with differences in biochemical failure (Table 1). Specifically, increased RNA expression of E2F3 (hazard ratio [HR] 1.11, P<.001), CTNNB1 (HR 1.49, PZ.002), and AR (HR 1.21, P<.001) were seen in patients who experienced biochemical failure. Expression of TP53 (HR 0.75, p<.001) and Gleason 7 disease (HR 0.62 vs Gleason 8-10, P<.001) were associated with decreased likelihood of biochemical failure. Clustering by pathologic T stage accounted for 10% of variance in biochemical failure indicating that the 4 genes add important information to the prediction of biochemical recurrence. Conclusion: Genomic data augments pretreatment clinical data as well as pathologic staging data in the stratification of patients at risk for biochemical failure following RP. RNA expression of E2F3, CTNNB1, AR, and TP53 is associated with differences in biochemical failure following RP. Clinically, these genes could aid in identifying patients who may benefit from more regionally directed pelvic and prostate radiation therapy. Further studies of the relationship between these genes and the development of prostate cancer could aid in future targeted therapies.