PURPOSE: This study was conducted to determine the value of prostate-specific antigen (PSA) as a pretherapy prognostic factor for localized prostate cancer treated with primary irradiation (RT). PATIENTS AND METHODS: Between March 1987 and December 1990, 254 patients with pretherapy PSA determinations were treated for clinical stage A2 to C prostate adenocarcinoma. In conjunction with other prognostic factors, pretherapy PSA was evaluated to determine whether it had independent predictive value for disease outcome. RESULTS: Pretherapy PSA was highly and directly correlated with clinical stage, tumor grade, and acid phosphatase level. With a median follow-up duration of 24 months, 241 patients (95%) were fully assessable for disease outcome. In these patients, PSA and tumor grade were the sole independent predictive factors for tumor relapse (ie, clinically determined and/or increasing PSA level). The combination of pretherapy PSA and tumor grade information defined groups of patients with distinctly different outcome. For patients in low- (favorable PSA and tumor grade), intermediate- (favorable PSA or tumor grade), and high- (adverse PSA and tumor grade) risk categories, the actuarial rates of survival free of tumor relapse or increasing PSA level were 94%, 77%, and 42% at 3 years, respectively (P < .0001). CONCLUSION: Pretherapy PSA is a strongly independent prognostic factor for disease outcome following primary RT. The combination of adverse pretherapy PSA and unfavorable tumor grade identified a cohort of patients with a high risk of early treatment failure in whom combined modality therapy may be appropriately investigated.
PURPOSE: This study was conducted to determine the value of prostate-specific antigen (PSA) as a pretherapy prognostic factor for localized prostate cancer treated with primary irradiation (RT). PATIENTS AND METHODS: Between March 1987 and December 1990, 254 patients with pretherapy PSA determinations were treated for clinical stage A2 to C prostate adenocarcinoma. In conjunction with other prognostic factors, pretherapy PSA was evaluated to determine whether it had independent predictive value for disease outcome. RESULTS: Pretherapy PSA was highly and directly correlated with clinical stage, tumor grade, and acid phosphatase level. With a median follow-up duration of 24 months, 241 patients (95%) were fully assessable for disease outcome. In these patients, PSA and tumor grade were the sole independent predictive factors for tumor relapse (ie, clinically determined and/or increasing PSA level). The combination of pretherapy PSA and tumor grade information defined groups of patients with distinctly different outcome. For patients in low- (favorable PSA and tumor grade), intermediate- (favorable PSA or tumor grade), and high- (adverse PSA and tumor grade) risk categories, the actuarial rates of survival free of tumor relapse or increasing PSA level were 94%, 77%, and 42% at 3 years, respectively (P < .0001). CONCLUSION: Pretherapy PSA is a strongly independent prognostic factor for disease outcome following primary RT. The combination of adverse pretherapy PSA and unfavorable tumor grade identified a cohort of patients with a high risk of early treatment failure in whom combined modality therapy may be appropriately investigated.
Authors: Margaret Peggy Adamo; Jessica A Boten; Linda M Coyle; Kathleen A Cronin; Clara J K Lam; Serban Negoita; Lynne Penberthy; Jennifer L Stevens; Kevin C Ward Journal: Cancer Date: 2016-10-26 Impact factor: 6.860
Authors: Robert T Dess; Krithika Suresh; Michael J Zelefsky; Stephen J Freedland; Brandon A Mahal; Matthew R Cooperberg; Brian J Davis; Eric M Horwitz; Martha K Terris; Christopher L Amling; William J Aronson; Christopher J Kane; William C Jackson; Jason W D Hearn; Curtiland Deville; Theodore L DeWeese; Stephen Greco; Todd R McNutt; Daniel Y Song; Yilun Sun; Rohit Mehra; Samuel D Kaffenberger; Todd M Morgan; Paul L Nguyen; Felix Y Feng; Vidit Sharma; Phuoc T Tran; Bradley J Stish; Thomas M Pisansky; Nicholas G Zaorsky; Fabio Ynoe Moraes; Alejandro Berlin; Antonio Finelli; Nicola Fossati; Giorgio Gandaglia; Alberto Briganti; Peter R Carroll; R Jeffrey Karnes; Michael W Kattan; Matthew J Schipper; Daniel E Spratt Journal: JAMA Oncol Date: 2020-12-01 Impact factor: 31.777