National Comprehensive Cancer Network guidelines for the management of prostate cancer

Scherr, Douglas S.; Swindle, Peter; Scardino, Peter T.

doi:10.1016/s0090-4295(02)02395-6

Cited by 147 publications

(118 citation statements)

References 88 publications

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“…The NCCN has suggested deferring salvage hormonal therapy until documented metastatic or symptomatic disease. 2 Other authors, however, advocate early Figure 5. Patients with a short interval to biochemical failure were more likely to receive salvage androgen deprivation therapy (ADT) and received ADT earlier than those with late failures.…”

Section: Discussionmentioning

confidence: 99%

“…1 However, biochemical failure by itself does not necessarily portend a grave prognosis, a fact recognized both by an American Society of Therapeutic Radiation Oncology consensus panel and the National Comprehensive Cancer Network (NCCN) guidelines. 2,3 In fact, given the lack of clearly proven benefit of early salvage ADT, these bodies recommend that clinical failure-not biochemical failure-indicates the need for salvage ADT.…”

Section: Introductionmentioning

confidence: 99%

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Interval to biochemical failure as a biomarker for cause‐specific and overall survival after dose‐escalated external beam radiation therapy for prostate cancer

Kapadia

Olson

Sandler

et al. 2011

Cancer

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BACKGROUND:After external beam radiation therapy (EBRT) for prostate cancer, a short interval to biochemical failure of <18 months has been proposed as a surrogate for cause‐specific survival. Because EBRT dose influences biochemical failure, the authors investigated the interval to biochemical failure in a cohort of patients treated with dose‐escalated EBRT.METHODS:From 1998 to 2008, 710 patients were treated with EBRT (≥75 grays) ± androgen deprivation therapy (ADT) at the University of Michigan. Biochemical failure was defined using the Phoenix consensus definition (nadir + 2 ng/mL). A short interval to biochemical failure was defined as <18 months after completing radiotherapy and/or ADT. The associations between biochemical failure, the interval to biochemical failure, and clinical factors with cause‐specific survival (CSS) and overall survival (OS) were evaluated.RESULTS:There were 149 biochemical failures (21%), and short interval to biochemical failure accounted for 14% and 40% of biochemical failures in those with intermediate‐risk or high‐risk disease, respectively. Biochemical failure impacted CSS (P < .0001) but not OS (P = .36). However, a short interval to biochemical failure predicted decreased CSS (P < .0001; hazard ratio [HR], 5.6; 95% confidence interval [CI], 2.4‐13.0) and OS (P < .0001; HR, 4.8; 95% CI, 2.3‐10.3) when compared with a long interval to biochemical failure. The 8‐year OS was 78% without biochemical failure, compared with 87% with a long interval to biochemical failure (P = .1; HR, 0.7; 95% CI, 0.4‐1.1) and 38% with a short interval to biochemical failure (P < .0001; HR, 3.7; 95% CI, 2.3‐5.9). On multivariate analysis, a short interval to biochemical failure increased the risk of prostate cancer death (P < .0001; HR, 18.1; 95% CI, 8.4‐39) and all cause mortality (P = .0027; HR, 1.5; 95% CI, 1.2‐2.1), whereas a long interval to biochemical failure did not.CONCLUSIONS:The relation between the interval to biochemical failure, CSS, and OS was independently validated in patients treated with dose‐escalated EBRT. Further evaluation of the interval to biochemical failure as a surrogate endpoint is warranted. Cancer 2012. © 2011 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Interval to biochemical failure as a biomarker for cause‐specific and overall survival after dose‐escalated external beam radiation therapy for prostate cancer

Kapadia

Olson

Sandler

et al. 2011

Cancer

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“…The patients were divided into 2 groups according to whether they received adjuvant hormone treatment or not. Patients with low or intermediate risk according to National Comprehensive Cancer Network (NCCN) guidelines criteria [27] who had undergone radical prostatectomy were referred for follow-up alone. Adjuvant hormone therapy was recommended to all patients who had received radiation therapy and to high-risk patients undergoing radical prostatectomy.…”

Section: Subjectsmentioning

confidence: 99%

Psychological distress in men with prostate cancer receiving adjuvant androgen-deprivation therapy

Saini

Berruti

Cracco

et al. 2013

Urologic Oncology: Seminars and Original Investigations

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“…3 There are 2 evidence-based treatment paradigms for managing high-risk prostate cancer: external-beam radiation therapy (RT) with adjuvant androgen-deprivation therapy (RT þ H) and radical prostatectomy with adjuvant radiotherapy (S þ RT), and the latter approach is reserved for men whose prostatectomy specimens reveal pathologic T3 disease or positive margins. 4 These 2 therapies differ dramatically in terms of both treatment efficacy and toxicity profiles. Whereas RT þ H is associated with a lower risk of distant metastases, S þ RT leads to improved local control rates without the benefit of systemic therapy.…”

Section: Introductionmentioning

confidence: 99%

Primary radiotherapy versus radical prostatectomy for high‐risk prostate cancer

Parikh

Sher

2011

Cancer

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BACKGROUND: Two evidence-based therapies exist for the treatment of high-risk prostate cancer (PCA): externalbeam radiotherapy (RT) with hormone therapy (H) (RT þ H) and radical prostatectomy (S) with adjuvant radiotherapy (S þ RT). Each of these strategies is associated with different rates of local control, distant metastasis (DM), and toxicity. By using decision analysis, the authors of this report compared the quality-adjusted life expectancy (QALE) between men with high-risk PCA who received RT þ H versus S þ RT versus a hypothetical trimodality therapy (S þ RT þ H). METHODS: The authors developed a Markov model to describe lifetime health states after treatment for high-risk PCA. Probabilities and utilities were extrapolated from the literature. Toxicities after radiotherapy were based on intensity-modulated radiotherapy series, and patients were exposed to risks of diabetes, cardiovascular disease, and fracture for 5 years after completing H. Deterministic and probabilistic sensitivity analyses were performed to model uncertainty in outcome rates, toxicities, and utilities. RESULTS: RT þ H resulted in a higher QALE compared with S þ RT over a wide range of assumptions, nearly always resulting in an increase of >1 quality-adjusted life year with outcomes highly sensitive to the risk of increased all-cause mortality from H. S þ RT þ H typically was superior to RT þ H, albeit by small margins (<0.5 quality-adjusted life year), with results sensitive to assumptions about toxicity and radiotherapy efficacy. CONCLUSIONS: For men with high-risk PCA, RT þ H was superior to S þ RT, and the result was sensitive to the risk of all-cause mortality from H. Moreover, trimodality therapy may offer local and distant control benefits that lead to optimal outcomes in a meaningful population of men. Cancer 2012;118:258-

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National Comprehensive Cancer Network guidelines for the management of prostate cancer

Cited by 147 publications

References 88 publications

Interval to biochemical failure as a biomarker for cause‐specific and overall survival after dose‐escalated external beam radiation therapy for prostate cancer

Interval to biochemical failure as a biomarker for cause‐specific and overall survival after dose‐escalated external beam radiation therapy for prostate cancer

Psychological distress in men with prostate cancer receiving adjuvant androgen-deprivation therapy

Primary radiotherapy versus radical prostatectomy for high‐risk prostate cancer

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