OP3-06 IMPACT OF TIME TO BIOCHEMICAL RECURRENCE ON CANCER-SPECIFIC MORTALITY IN PATIENTS WITH HIGH-RISK PROSTATE CANCER TREATED WITH RADICAL PROSTATECTOMY: A COMPETING-RISKS REGRESSION ANALYSIS

Abstract

You have accessJournal of UrologyOutstanding Posters: Oncology1 Apr 2014OP3-06 IMPACT OF TIME TO BIOCHEMICAL RECURRENCE ON CANCER-SPECIFIC MORTALITY IN PATIENTS WITH HIGH-RISK PROSTATE CANCER TREATED WITH RADICAL PROSTATECTOMY: A COMPETING-RISKS REGRESSION ANALYSIS Giorgio Gandaglia, Firas Abdollah, Marco Bianchi, Maxine Sun, Pierre Karakiewicz, Shahrokh F. Shariat, Steven Joniau, Martin Spahn, Paolo Gontero, Giansilvio Marchioro, Bertrand Tombal, Patrick Bastian, Francesco Montorsi, Henk Van Der Poel, Rafael Sanchez-Salas, and Alberto Briganti Giorgio GandagliaGiorgio Gandaglia More articles by this author , Firas AbdollahFiras Abdollah More articles by this author , Marco BianchiMarco Bianchi More articles by this author , Maxine SunMaxine Sun More articles by this author , Pierre KarakiewiczPierre Karakiewicz More articles by this author , Shahrokh F. ShariatShahrokh F. Shariat More articles by this author , Steven JoniauSteven Joniau More articles by this author , Martin SpahnMartin Spahn More articles by this author , Paolo GonteroPaolo Gontero More articles by this author , Giansilvio MarchioroGiansilvio Marchioro More articles by this author , Bertrand TombalBertrand Tombal More articles by this author , Patrick BastianPatrick Bastian More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , Henk Van Der PoelHenk Van Der Poel More articles by this author , Rafael Sanchez-SalasRafael Sanchez-Salas More articles by this author , and Alberto BrigantiAlberto Briganti More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2327AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Previous studies reported contrasting results regarding the association between time to biochemical recurrence (BCR) and the risk of dying from prostate cancer (PCa) after radical prostatectomy (RP). Of note, none of them accounted for the risk of other causes mortality. To address this issue, we aimed at evaluating the impact of time to BCR on cancer-specific mortality (CSM) relying on competing-risks regression analyses in men with high risk PCa. METHODS Using a multi-institutional cohort, 2,065 patients treated with RP for high-risk PCa according to the NCCN guidelines (clinical stage ≥T3 and/or biopsy Gleason score [GS] 8-10 and/or preoperative PSA ≥20ng/ml) between 1991 and 2011 were identified. No patient received neo-adjuvant or adjuvant therapy. BCR was defined as two consecutive PSA values ≥0.2 ng/ml after RP. Only patients who experienced BCR after surgery were included (n=823). First, we dichotomized time from surgery to BCR according to the most informative cut-off predicting CSM. Second, cumulative incidence CSM rates were generated according to the dichotomized time to BCR and compared with the Gray test. Finally, multivariate (MVA) competing-risks regression models were used to test the effect of time from surgery to BCR on the risk of CSM after accounting for the risk of dying from other causes. RESULTS Mean age at RP was 64.5 years (median 65). Median follow-up was 109 months (median: 111.3). The overall 5- and 10-year CSM were 6.3 (95% confidence interval [CI]: 4.6-8.9%) and 14.8% (95% CI: 16.3-24.4%), respectively. The most informative cut-off for time from RP to BCR in predicting CSM was 35 months (P<0.001). Patients who experienced BCR within 35 months from RP had significantly higher 10-year CSM rates compared to their counterpart who experienced BCR after 35 months from RP (19.1 vs. 4.4%, respectively; P<0.001). In MVA competing-risks regression analyses, time from RP to BCR represented a significant predictor of CSM (Hazard ratio [HR]: 0.97; P<0.001). Additionally, pathological stage and GS were associated with higher risk of dying from PCa (all P≤0.04). CONCLUSIONS The time elapsed between surgery and BCR is an independent predictor of CSM in patients with high-risk PCa treated with RP. Patients recurring within 3 years from RP might benefit from more aggressive, multimodal treatments. Conversely, those experiencing a late BCR should be considered at low-risk of subsequent CSM. Such information can help provide physicians with better follow-up protocols. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e853 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Giorgio Gandaglia More articles by this author Firas Abdollah More articles by this author Marco Bianchi More articles by this author Maxine Sun More articles by this author Pierre Karakiewicz More articles by this author Shahrokh F. Shariat More articles by this author Steven Joniau More articles by this author Martin Spahn More articles by this author Paolo Gontero More articles by this author Giansilvio Marchioro More articles by this author Bertrand Tombal More articles by this author Patrick Bastian More articles by this author Francesco Montorsi More articles by this author Henk Van Der Poel More articles by this author Rafael Sanchez-Salas More articles by this author Alberto Briganti More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...