Biochemical outcome after radical prostatectomy or external beam radiation therapy for patients with clinically localized prostate carcinoma in the prostate specific antigen era

D’Amico, Anthony V.; Whittington, Richard; Malkowicz, S. Bruce; Cote, Kerri; Loffredo, Marian; Schultz, Delray; Chen, Ming‐Hui; Tomaszewski, John E.; Renshaw, Andrew A.; Wein, Alan J.; Richie, Jerome P.

doi:10.1002/cncr.10657

Cited by 319 publications

(190 citation statements)

References 21 publications

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“…The BMI classes were defined as normal (less than 25 kg/m 2 ), overweight (25 to 29.9 kg/m 2 ), obese (30 to 34.9 kg/m 2 ), and very obese (35 kg/m 2 or more). Patients were categorized as having low, intermediate, or high-risk disease using the stratification system described by D'Amico et al 10 Recurrence was defined as two consecutive serum PSA levels of 0.2 ng/mL or more or documentation of any second treatment at least 6 months after RP (patients receiving a second treatment sooner than 6 months after RP were determined to have received adjuvant therapy and were therefore excluded). The date of recurrence was defined as the date of the first PSA level that was 0.2 ng/mL or greater or the date of second treatment; patients without recurrence were censored at the date of the last recorded PSA level.…”

Section: Methodsmentioning

confidence: 99%

Impact of obesity on prostate cancer recurrence after radical prostatectomy: Data from CaPSURE

Bassett

Cooperberg

Sadetsky

et al. 2005

Urology

123

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Objectives. To determine the association between obesity and prostate cancer recurrence after primary treatment with radical prostatectomy. Methods. Data were abstracted from CaPSURE, a disease registry of 10,018 men with prostate cancer. We included 2131 men who had undergone radical prostatectomy between 1989 and 2003 and had body mass index (BMI) information available. Recurrence was defined as two consecutive prostate-specific antigen (PSA) levels of 0.2 ng/mL or greater or any second treatment. Patients were risk stratified using the PSA level, Gleason grade, and clinical T stage. Results. Patients were followed up for a median of 23 months. Of the 2131 patients, 251 (12%) developed recurrence at a median of 13 months (range 1 to 107); 183 (9%) of these men had PSA failure and 68 (3%) received a second treatment. After adjusting for risk group, ethnicity, age, and comorbidities, a significant association was found between an increasing BMI and disease recurrence (P ϭ 0.028). Very obese patients (BMI 35 kg/m 2 or more) were 1.69 times more likely to have recurrence relative to men of normal weight (BMI less than 25.0 kg/m 2 ; 95% confidence interval [CI] 1.01 to 2.84). An increasing PSA level (P Ͻ0.0001) and Gleason grade (P Ͻ0.0001) were also associated with recurrence. Ethnicity was not significantly associated with either BMI or PSA recurrence (P ϭ 0.685 and P ϭ 0.068, respectively). Conclusions. The results of our study have shown that obesity is an independent predictor of prostate cancer recurrence. Because of the increased comorbidities and greater rates of recurrence, obese individuals undergoing radical prostatectomy need vigilant follow-up care. UROLOGY 66: 1060-1065, 2005.

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Section: Methodsmentioning

confidence: 99%

Impact of obesity on prostate cancer recurrence after radical prostatectomy: Data from CaPSURE

Bassett

Cooperberg

Sadetsky

et al. 2005

Urology

123

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“…[12][13][14] It is encouraging to see that urologists in England have largely moved away from selecting patients with a preoperative PSA of 410 ng/ml for RRP with their associated higher rates of nonorgan-confined disease. 15 The median PSA in 1999 was 9.2 ng/ml (Table 1).…”

Section: Discussionmentioning

confidence: 99%

“…[16][17][18] In concordance with the literature, patients with a PSA of 420 should not undergo radical surgery (estimated 5 y biochemical recurrence-free survival 20% (95% CI: 6-41). 15,16 Equally, patients with a PSA of 11-20 and clinical stage T2 disease have only a minor benefit from radical surgery (estimated 5-y biochemical recurrencefree survival 54% (95% CI: 37-69)).…”

Section: Discussionmentioning

confidence: 99%

Learning curve and stage migration of a radical retropubic prostatectomy series over a 10-y period

Winkler

Gillatt

2004

Prostate Cancer Prostatic Dis

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Objective: To show the impact of learning curve and patient selection on complication rate and biochemical recurrence-free survival of a UK radical prostatectomy series for localised prostate cancer and to model the influence of common preoperative variables on biochemical recurrence after controlling for learning curve. Patients and Methods: From 1989 to 1999, 280 of 350 patients who underwent anatomical radical retropubic prostatectomy (RRP) at our institution had complete records and follow-up of at least 1 y. After exclusions of preoperative staging, factors reflecting the learning curve, early complications and prostate-specific antigen (PSA) outcome were recorded on 217 patients. Procedures before 1995 were compared with procedures after 1995. Results: Comparison of the two groups showed a significant decrease in operating time (mean 152 vs 130 min), blood loss (mean 1500 vs 1000 ml), transfusion rate (83 vs 42%) and hospital stay (mean 7 vs 6 days). Median preoperative PSA changed significantly from 13.2 to 11.5 ng/ml. Only 17% were diagnosed by rectal examination compared to 27% in the early years. The number of clinical T1 tumours increased from 33 to 47%. This did lead to an increase of organ-confined tumours on pathological staging by 25%. Biochemical recurrence-free survival improved significantly after 1995. After controlling for the learning curve PSA and clinical stage were significant predictors of PSA recurrence. Conclusion: Time trends of case selection, stage migration and a steep learning curve are shown over a 10-y period. Factors associated with the learning curve as well as case selection have a significant impact on outcome. There may be other as yet not specified factors over time, which have a significant impact on PSA recurrence-free survival. Patients with a PSA of 20 ng/ml and above have a poor outcome and do not appear to be suitable candidates for RRP.

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“…Lifestylerelated factor included body mass index (BMI) categorized as <25.0, 25.0-29.9, and >30 kg/m 2 . Risk of prostate cancer recurrence was assessed by a modification of the D'Amico risk classification 32 in which low risk was defined as clinical stage T1 or 2a, Gleason score <7, prostate-specific antigen (PSA) level <10 ng/mL; intermediate risk as stage T2b, Gleason score 7, or PSA between 10 and 20 ng/mL; and high risk as any stage greater than T2b, Gleason score >7, or PSA level >20 ng/mL. Comorbidities were assessed from a self-reported checklist completed upon enrollment in the study that includes 11 categories of common conditions.…”

Section: Covariatesmentioning

confidence: 99%

Impact of androgen deprivation on physical well‐being in patients with prostate cancer

Sadetsky

Greene

Cooperberg

et al. 2011

Cancer

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BACKGROUND: As androgen deprivation therapy (ADT) becomes a standard of treatment for men with recurrent or metastatic prostate cancer, evaluation of adverse effects associated with this treatment is needed. In this study, the authors evaluated the effect of ADT administered as monotherapy and in combination with local treatment on physical well-being in a longitudinal sample of men with prostate cancer. METHODS: Exposure to ADT was defined by 3 groups: local (local treatment only), combination (local treatment with adjuvant and/or neoadjuvant ADT), and primary ADT. Associations between exposure to ADT and physical well-being measured by self-reported health-related quality of life outcomes over time were evaluated by repeated measures analysis using mixed modeling. Estimates adjusted for various clinical and demographic variables are reported. RESULTS: A total of 2922 men, who completed both pretreatment and follow-up health-related quality of life assessment, were identified from the CaPSURE (Cancer of the Prostate Strategic Urologic Research Endeavor) registry. During 24 months of follow-up, exposure to ADT was associated with worse physical well-being compared with local treatment at all time points (P < .001). Being exposed to ADT as primary therapy was associated with more severe declines compared with combination therapy. CONCLUSIONS: The potential consequence of decline in physical well-being in patients exposed to ADT has to be included in treatment decision making. Cancer 2011;117:4406-

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Biochemical outcome after radical prostatectomy or external beam radiation therapy for patients with clinically localized prostate carcinoma in the prostate specific antigen era

Cited by 319 publications

References 21 publications

Impact of obesity on prostate cancer recurrence after radical prostatectomy: Data from CaPSURE

Impact of obesity on prostate cancer recurrence after radical prostatectomy: Data from CaPSURE

Learning curve and stage migration of a radical retropubic prostatectomy series over a 10-y period

Impact of androgen deprivation on physical well‐being in patients with prostate cancer

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