MP22-19 PREDICTION AND STRATIFICATION OF THE BIOCHEMICAL RECURRENCE IN PATIENTS WITH HIGH-RISK PROSTATE CANCER AFTER LOW DOSE RATE PERMANENT SEED IMPLANTATION

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Radiation Therapy1 Apr 2018MP22-19 PREDICTION AND STRATIFICATION OF THE BIOCHEMICAL RECURRENCE IN PATIENTS WITH HIGH-RISK PROSTATE CANCER AFTER LOW DOSE RATE PERMANENT SEED IMPLANTATION Yu Ozawa, Masanori Hasegawa, Noriaki Santo, Yasuto Yagi, Toru Nishiyama, Ryo Yabusaki, Keisuke Aoki, Ken Nakamura, Choichiro Ozu, Kazuhito Toya, Masanori Yorozu, and Shiro Saito Yu OzawaYu Ozawa More articles by this author , Masanori HasegawaMasanori Hasegawa More articles by this author , Noriaki SantoNoriaki Santo More articles by this author , Yasuto YagiYasuto Yagi More articles by this author , Toru NishiyamaToru Nishiyama More articles by this author , Ryo YabusakiRyo Yabusaki More articles by this author , Keisuke AokiKeisuke Aoki More articles by this author , Ken NakamuraKen Nakamura More articles by this author , Choichiro OzuChoichiro Ozu More articles by this author , Kazuhito ToyaKazuhito Toya More articles by this author , Masanori YorozuMasanori Yorozu More articles by this author , and Shiro SaitoShiro Saito More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.730AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Treatment of high-risk prostate cancer (PCa) remains challenging for urologists. The present study was undertaken to identify risk factors for the biochemical recurrence (BCR) in patients with high-risk PCa who underwent low dose rate permanent seed implantation brachytherapy with iodine-125 (LDR). METHODS Medical records of 335 patients with high-risk PCa identified by NCCN risk stratification treated with LDR during the period of 2004-2015 at our institution have been reviewed. All patients received extra beam radiation therapy after LDR. Possible risk factors assessed for the future BCR included age, PSA, prostate volume, histological findings of biopsy specimens, neoadjuvant hormone therapy and local extent of disease evaluated by pelvic MRI. BCR free survival rates were constructed using the Kaplan-Meier method. Risk factors for BCR were evaluated by the log-rank test and multivariate Cox proportional hazard model with a stepwise selection procedure. RESULTS The Kaplan-Meier analysis showed that the 5- or 10-year BCR free survival rates were 86.7%, and 78.8%, respectively. Multivariate analysis demonstrated that grade group 5 (Hazard ratio; HR 3.75, p<0.01), cT3 (HR 2.03, p<0.04), PSA >20ng/ml (HR 2.45, p<0.05) and no neoadjuvant hormone therapy (HR 2.16, p<0.05) were significant prognostic factors. The patients were stratified into a good-risk group (0 or 1 risk factor), intermediate-risk group (2 risk factors), and poor-risk group (3 risk factors). There were significant differences in the BCR free survival among the groups; p<0.01 for low- vs. intermediate-risk group, and p<0.01 for intermediate- vs. high-risk group. The 5- or 10-year BCR free survivals rates were 92.4%, 83.1%, and 75.3%, 72.5%, and 26.7%, 26.7% in good-, intermediate-, and poor-risk patients, respectively. CONCLUSIONS These results indicate that grade group 5, cT3, PSA >20ng/ml and no neoadjuvant hormone therapy were independent risk factors for the BCR in patients with high-risk PCa treated with LDR. The combination of these factors may be helpful to identify candidates for additional treatments to control disease progression. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e280 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Yu Ozawa More articles by this author Masanori Hasegawa More articles by this author Noriaki Santo More articles by this author Yasuto Yagi More articles by this author Toru Nishiyama More articles by this author Ryo Yabusaki More articles by this author Keisuke Aoki More articles by this author Ken Nakamura More articles by this author Choichiro Ozu More articles by this author Kazuhito Toya More articles by this author Masanori Yorozu More articles by this author Shiro Saito More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...