Salvage Therapy for Prostate Cancer: AUA/ASTRO/SUO Guideline Part II: Treatment Delivery for Non-metastatic Biochemical Recurrence After Primary Radical Prostatectomy

Morgan, Todd M.; Boorjian, Stephen A.; Buyyounouski, Mark K.; Chapin, Brian F.; Chen, David Y. T.; Cheng, Heather H.; Chou, Roger; Jacene, Heather A.; Kamran, Sophia C.; Kim, Sennett K.; Kirkby, Erin; Luckenbaugh, Amy N.; Nathanson, Ben J.; Nyame, Yaw A.; Posadas, Edwin M.; Tran, Phuoc T.; Chen, Ronald C.

doi:10.1097/ju.0000000000003891

Cited by 5 publications

(1 citation statement)

References 42 publications

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“… 3 Therefore, guidelines established from a collaboration among the American Urology Association, American Society for Radiation Oncology and Society of Urologic Oncology recommend androgen‐deprivation therapy, in addition to salvage radiation therapy, for patients with biochemical recurrence (BCR) after RP who have persistent PSA. 4 In a recent review article, the incidence of persistent PSA ranged between 3.1% and 34.6%, with a median of 11.0%. 2 Previous studies have shown that several clinicopathological variables, such as the D'Amico risk (high risk vs. medium and low risk), postoperative International Society of Urologic Pathology (ISUP) grade group ≥4, pathological T stage ≥pT3, extraprostatic extension (EPE), seminal vesicle invasion (SVI), positive surgical margins (PSMs) and lymphovascular invasion (LVI), were independently associated with persistent PSA after robot‐assisted RP (RARP).…”

Section: Introductionmentioning

confidence: 99%

Cribriform pattern 4/intraductal carcinoma of the prostate and persistent prostate‐specific antigen after radical prostatectomy

Sasaki,

Kobayashi,

Uchida

et al. 2024

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ObjectivesThe objective of this study is to identify the effect of cribriform pattern 4 carcinoma/intraductal carcinoma of the prostate (CC/IDCP) on persistent prostate‐specific antigen (PSA) levels after robot‐assisted radical prostatectomy (RARP) in patients with localized prostate cancer (PCa).Patients and MethodsThis retrospective study included 730 consecutive patients with localized PCa who underwent RARP at Mie University (n = 392) and Aichi Medical University (n = 338) between 2015 and 2021. Patients with clinically metastatic PCa (cN1 and cM1) and those who received neoadjuvant and/or adjuvant therapy before biochemical recurrence were excluded. We evaluated the effects of CC/IDCP on persistent PSA levels after RARP. Persistent PSA was defined as PSA level ≥0.2 ng/mL at 1 month postoperatively and consecutively thereafter. Using factors from logistic regression analysis, models were developed to predict persistent PSA levels.ResultsApproximately 6.3% (n = 46) of the patients had persistent PSA levels. Patients with biopsy CC/IDCP (bCC/IDCP) and pathological CC/IDCP (pCC/IDCP) based on RARP specimens were 11.6% (85/730) and 36.5% (267/730), respectively. Multivariate analysis of the prediction of persistent PSA levels using preoperative factors revealed that PSA density, percentage of positive cancer cores, biopsy grade group and bCC/IDCP were independent prognostic factors. Furthermore, multivariate analysis of the prediction of persistent PSA levels using postoperative factors, excluding pN1, revealed that pathological grade group, pCC/IDCP, seminal vesicle invasion and lymphovascular invasion were independent prognostic factors. In the receiver operating characteristic curve analysis for predicting persistent PSA after RARP, areas under the receiver operating characteristic curve for the model with preoperative factors, postoperative factors, including pN1, and postoperative factors, excluding pN1, were 0.827, 0.833 and 0.834, respectively.ConclusionsbCC/IDCP predicted persistent PSA after RARP in the overall population, while pCC/IDCP predicted persistent PSA only when the pN1 population was excluded. This may be useful for predicting susceptible patients with worse outcomes.

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Section: Introductionmentioning

confidence: 99%

Cribriform pattern 4/intraductal carcinoma of the prostate and persistent prostate‐specific antigen after radical prostatectomy

Sasaki,

Kobayashi,

Uchida

et al. 2024

BJUI Compass

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Intensifying Salvage Therapy in Prostate-specific Antigen Recurrent Prostate Cancer After Radical Prostatectomy with Apalutamide, Salvage Radiation, and Docetaxel: The Phase 2 STARTAR Trial

Zhang,

Howard,

Koontz

et al. 2024

European Urology Oncology

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Comparison of oncological outcomes between extended and no pelvic lymph node dissection in patients with high- or very high-risk prostate cancer: a multi-institutional study

Washino,

Kawase,

Shimbo

et al. 2024

Prostate International

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Salvage Therapy for Prostate Cancer: AUA/ASTRO/SUO Guideline Part II: Treatment Delivery for Non-metastatic Biochemical Recurrence After Primary Radical Prostatectomy

Abstract: Conclusions: Optimizing and personalizing the approach to salvage therapy remains an ongoing area of work in the field of genitourinary oncology and represents an area of research and clinical care that requires wellcoordinated, multi-disciplinary efforts.

Cited by 5 publications

References 42 publications

Cribriform pattern 4/intraductal carcinoma of the prostate and persistent prostate‐specific antigen after radical prostatectomy

Cribriform pattern 4/intraductal carcinoma of the prostate and persistent prostate‐specific antigen after radical prostatectomy

Intensifying Salvage Therapy in Prostate-specific Antigen Recurrent Prostate Cancer After Radical Prostatectomy with Apalutamide, Salvage Radiation, and Docetaxel: The Phase 2 STARTAR Trial

Comparison of oncological outcomes between extended and no pelvic lymph node dissection in patients with high- or very high-risk prostate cancer: a multi-institutional study

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