Four prognostic groups predict long-term survival from prostate cancer following radiotherapy alone on radiation therapy oncology group clinical trials

Roach, Mack; Lu, Jiandong; Pilepich, Miljenko V.; Asbell, Sucha O.; Mohuidden, Mohammed; Terry, Roger; Grignon, David J.

doi:10.1016/s0360-3016(00)00578-2

Cited by 159 publications

(68 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A direct comparison of the outcomes of surgery and radiation are inadequate because of inherent selection biases, the Gleason score upgrading or stage migration after surgery. Nevertheless, this issue could be partially solved using data from the RTOG trials which compared RT vs. a combined approach using RT and ADT [13]. The outcomes of another long-term study comparing RT vs. RT with concomitant ADT were reported by Bolla et al (14).…”

Section: Discussionmentioning

confidence: 99%

Oncological outcomes of surgery in very high risk pT3b prostate cancer

Milonas¹,

Smailytė²,

Trumbeckas³

et al. 2011

AML

View full text Add to dashboard Cite

Background. The aim of the study was to present the oncologic outcomes and to determine the prognostic factors of overall (OS) and cancer-specific survival (CSS) as well as disease-progression-free survival (DPFS) after surgery for pT3b prostate cancer.Materials and methods. In 2002-2007, a pT3b stage after radical prostatectomy was detected in 56 patients. Patients were divided into groups according to the prostate-specific antigen (PSA) level (<10 vs. 10-20 vs. >20 ng/ml), lymph nodes status (N0 vs. Nx vs. N1) and the Gleason score (6-7 vs. 8-10). The Kaplan-Meier analysis was used to calculate OS, CSS and DPFS. The Cox regression was used to identify the predictive factors of survival.Results. Five-year OS, CSS and DPFS rates were 75.1%, 79.6% and 79.3%, respectively. The survival was significantly different when comparing the Gleason 6-7 and 8-10 groups. The 5-year OS, CSS and DPFS were 91.2% vs. 48.6%, 97.1% vs. 51.1% and 93.8 vs. 51.1%, respectively. There was no difference in survival among the groups with a different PSA level. The OS and CSS but not DPFS were significantly different when comparing the N0 and N1 groups. The 5-year OS and CSS was 84.4% vs. 37.5% and 87.3% vs. 47.6%, respectively. The specimen Gleason score was a significant predictor of OS and CSS. The risk of death increased up to 4-fold when a Gleason score 8-10 was present at the final pathology.Conclusions. Radical prostatectomy may offer acceptable CSS, DPFS and OS rates in pT3b PCa. However, outcomes in patients with N1 and specimen Gleason ≥8 were significantly worse, suggesting the need of multimodality treatment in such cases.

show abstract

Section: Discussionmentioning

confidence: 99%

Oncological outcomes of surgery in very high risk pT3b prostate cancer

Milonas¹,

Smailytė²,

Trumbeckas³

et al. 2011

AML

View full text Add to dashboard Cite

show abstract

“…GS, T stage and pathologic lymph node status have been described as major independent predictors of death due to prostate cancer in men treated with external beam radiotherapy. Roach et al [15] The 5-, 10-and 15-year disease-specific survival was 96%, 86% and 72% for group 1; 94%, 75% and 61% for group 2; 83%, 62% and 39% for group 3; and 64%, 34% and 27% for group 4.…”

Section: Radiotherapymentioning

confidence: 94%

Management of locally advanced prostate cancer

Payne¹

2008

Asian J Androl

View full text Add to dashboard Cite

The management of all stages of prostate cancer is an increasingly complex process and involves a variety of available treatments and many disciplines. Despite prostate-specific antigen (PSA) testing, the presentation of prostate cancer at a locally advanced stage is common in the UK, accounting for one-third of all new cases. There is no universally accepted definition of locally advanced prostate cancer; the term is loosely used to encompass a spectrum of disease profiles that show high-risk features. Men with high-risk prostate cancer generally have a significant risk of disease progression and cancer-related death if left untreated. High-risk patients, including those with locally advanced disease, present two specific challenges. There is a need for local control as well as a need to treat any microscopic metastases likely to be present but undetectable until disease progression. The optimal treatment approach will therefore often necessitate multiple modalities. The exact combinations, timing and intensity of treatment continue to be strongly debated. Management decisions should be made after all treatments have been discussed by a multidisciplinary team (including urologists, oncologists, radiologists, pathologists and nurse specialists) and after the balance of benefits and side effects of each therapy modality has been considered by the patient with regard to his own individual circumstances. This article reviews the current therapy options.

show abstract

“…Similarly, in a report by Pound et al [15], the rate of remaining metastases-free at 7 years was 29% in patients with Gleason 8 or above. With radiation treatment alone in patients with high-risk disease, the 5-year rates of disease control are only 40% and 5-year survival ranges from 50% to 60% [16,17].…”

Section: Surgery and Radiation As Monotherapymentioning

confidence: 99%