339 EARLY BIOCHEMICAL RECURRENCE FOLLOWING RADICAL PROSTATECTOMY DOES NOT ALTER SURVIVAL IN MEN WITH LOW RISK PROSTATE CANCER

Abstract

You have accessJournal of UrologyProstate Cancer: Epidemiology and Natural History II1 Apr 2012339 EARLY BIOCHEMICAL RECURRENCE FOLLOWING RADICAL PROSTATECTOMY DOES NOT ALTER SURVIVAL IN MEN WITH LOW RISK PROSTATE CANCER Anthony Ta, Damien Bolton, Graham Giles, Gianluca Severi, Melisa Bagnato, David Muller, and Rodney Syme Anthony TaAnthony Ta Melbourne, Australia More articles by this author , Damien BoltonDamien Bolton Melbourne, Australia More articles by this author , Graham GilesGraham Giles Melbourne, Australia More articles by this author , Gianluca SeveriGianluca Severi Melbourne, Australia More articles by this author , Melisa BagnatoMelisa Bagnato Melbourne, Australia More articles by this author , David MullerDavid Muller Melbourne, Australia More articles by this author , and Rodney SymeRodney Syme Melbourne, Australia More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.400AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Early biochemical recurrence (BCR) following radical prostatectomy (RP) is an adverse prognosticator of prostate cancer-specific mortality (PCM). We evaluated the temporal relationship between BCR and PCM from a prospective whole-of-population cancer registry. METHODS The Victorian Radical Prostatectomy Register is a state-wide registry of all males who underwent RP in Victoria, Australia, between 1995 and 2000. RP patients were identified via record linkage to a state cancer registry. Deaths were identified via linkage to the Victorian Registry of Births, Deaths, and Marriages. PSA and clinical variables were obtained via access to hospital records and pathology laboratories as approved by the institutional review board. BCR was defined as two consecutive PSA readings >0.2μg/L. Clinical and pathologic predictors of PCM were identified with multivariate Cox regression. Poisson regression models were employed to calculate risk of PCM per 10-person years as a function of time of BCR. Gleason score and tumor stage were used as covariates. RESULTS The median age at diagnosis was 62 years and median follow-up was 10.3 years. 695 (33%) of 2116 men experienced BCR after RP; 82% of those recurred within 5 years of surgery. 250 men died of all causes; 81 men (3.8%) died from prostate cancer. The time interval between RP and BCR was a strong predictor of PCM in men with adverse disease, but had no correlation with PCM in men with low risk disease (Fig 1). The predicted mortality rate per 10 person-years after BCR for men with low risk disease (Gleason score <3+4=7 and <pT2c) was 0.04 if BCR occurred at 2 years or 5 years. Conversely, predicted mortality rate for men with high risk disease (Gleason score >4+3=7 and >pT3a) was 0.50 and 0.14 with BCR at 2 and 5 years, respectively. The effect of BCR on survival in men with low-risk disease was minimal. CONCLUSIONS Findings from this whole-of-population registry confirm that men with favourable clinico-pathologic features at the time of RP (Gleason <3+4 and <pT2c) are at low risk of dying from their disease even if they experience early biochemical recurrence. In the unfortunate event of a BCR, this sub-group may be counselled regarding their favourable long-term prognosis. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e138 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Anthony Ta Melbourne, Australia More articles by this author Damien Bolton Melbourne, Australia More articles by this author Graham Giles Melbourne, Australia More articles by this author Gianluca Severi Melbourne, Australia More articles by this author Melisa Bagnato Melbourne, Australia More articles by this author David Muller Melbourne, Australia More articles by this author Rodney Syme Melbourne, Australia More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...