MP53-20 THE PREDICTIVE VALUE OF 2-YEAR POST-TREATMENT BIOPSY AFTER PROSTATE CANCER CONFORMAL RADIOTHERAPY FOR FUTURE OVERALL SURVIVAL AND BIOCHEMICAL FAILURE. THE RESULTS OF THE UK MRC RT01 TRIAL.

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening II1 Apr 2014MP53-20 THE PREDICTIVE VALUE OF 2-YEAR POST-TREATMENT BIOPSY AFTER PROSTATE CANCER CONFORMAL RADIOTHERAPY FOR FUTURE OVERALL SURVIVAL AND BIOCHEMICAL FAILURE. THE RESULTS OF THE UK MRC RT01 TRIAL. Antoine Kass-iliyya, Gordana Jovic, Matthew Sydes, Cyril Fisher, Claire Murphy, David Nicol, and David Dearnaley Antoine Kass-iliyyaAntoine Kass-iliyya More articles by this author , Gordana JovicGordana Jovic More articles by this author , Matthew SydesMatthew Sydes More articles by this author , Cyril FisherCyril Fisher More articles by this author , Claire MurphyClaire Murphy More articles by this author , David NicolDavid Nicol More articles by this author , and David DearnaleyDavid Dearnaley More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1651AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives There is still an uncertainty regarding the significance of prostate biopsy status performed at 2 years after conformal radiotherapy (CFRT) used for treatment of localized prostate cancer. The objective of this analysis is to determine whether prostate biopsy status at around 2 years is predictive of overall survival (OS) and long-term biochemical progression free survival (bPFS). Methods Between January 1998 and December 2001, 843 consenting men with localized prostate cancer were randomized in to the MRC RT01 trial to receive either Control-64Gy or Escalated-74Gy of CFRT. Patients were stratified according to the risk of seminal vesicles (SV) involvement. As part of the trial’s protocol, post-CFRT prostate biopsies were requested at two years from the start of RT. Exclusion criteria for this analysis included biopsies performed before 18 months or after 36 months of starting radiotherapy and any evidence of biochemical failure or progression before or on the date of the biopsy. Analyses were performed using standard survival analysis methods with a landmark approach; hazard ratios (HR) are presented. Results 223 patient biopsies were taken and reviewed by a central pathologist. 46 of these patients met the exclusion criteria, leaving 177 patients for the main analysis. Baseline and patients characteristics were comparable in both groups. Median follow up was 7.8 years. In total, 64 bPFS events occurred: 46/145 in patients with negative biopsies, 6/18 in suspicious and 12/14 in positive. p: <0.001. HR: 4.69 (95%CI 2.44-9.01). Figure (1) Four deaths secondary to prostate cancer occurred: 1 (0.7%) in patient with negative biopsy and 3 (21.4%) in patients with positive biopsies. Twenty-seven deaths from any cause occurred: 21/145 (14%) in patients with negative biopsies, 2/18 (11%) in suspicious and 4/14 (29%) in positive. p: 0.410. HR: 1.58 (95%CI 0.53-4.71). Conclusions The risk of biochemical failure in patients with positive biopsies at 2 years is almost five times higher than in patients with negative or suspicious biopsies and the risk of death from any cause is about 1.6 times higher. Post-treatment prostate biopsies are a strong predictor of future biochemical failure. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e596-e597 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Antoine Kass-iliyya More articles by this author Gordana Jovic More articles by this author Matthew Sydes More articles by this author Cyril Fisher More articles by this author Claire Murphy More articles by this author David Nicol More articles by this author David Dearnaley More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...