MP74-09 P2PSA AND DERIVATIVES (%P2PSA AND PHI) ACCURATELY PREDICT PROSTATE CANCER IN OBESE MEN FROM A MULTICENTER PROSPECTIVE EUROPEAN STUDY

Abstract

be a more robust determinant of patient outcome compared with the American Society for Therapeutic Radiology and Oncology (ASTRO) definition (three consecutive increases of PSA). However, the Phoenix definition is not suitable for comparing BF of BT and that of radical prostatectomy (RP) because BF after RP is diagnosed when PSA >0.2ng/mL and a large portion of the patients undergo salvage therapy before PSA reaches 2.0 ng/mL. The objective of this study is to compare a new definition of BF, PSA>0.2ng/mL with three consecutive increases (NTMC definition), with the Phoenix definition and the ASTRO definition. METHODS: A total of 1442 patients with clinically localized PCa were treated with BT between September 2003 and October 2010 at our institution, and followed at least 36 months (22 to 118, median 70.0 months). The patients were treated with seed implantation using I-125 with or without EBRT combination. The patients may have neoadjuvant androgen deprivation therapy (ADT), but ADT after BT was not performed in any of the cases before the diagnosis of disease recurrence. Sesitivity and specificity of each definition are calculated and compared. True failure is confirmed by clinical failure. Possible failure (PF) is defined as rising PSA toward the end of observation without clear evidence of clinical recurrence. There were 46 PF cases and they were excluded from the study. RESULTS: Sensitivity and specificity of the Phoenix, the ASTRO, and our definition are shown in a table. NTMC definition showed much higher sensitivity and slightly lower specificity compared to the Phoenix definition. NTMC definition had similar sensitivity and higher specificity to the ASTRO definition. Neoadjuvant ADT lowered sensitivity of the Phoenix definition, and raised specificity of the Phoenix and our definition. CONCLUSIONS: NTMC definition of BF after BT such as PSA>0.2ng/mL with three consecutive increases showed sufficiently high sensitivity and specificity. The definition is useful especially the cases with neoadjuvant ADT, or when comparing therapeutic effect of BT and RP.