Risk profiles to predict PSA relapse-free survival for patients undergoing permanent prostate brachytherapy

Area of Science:

• Oncology
• Radiation Oncology
• Urology

Background:

• Prostate-specific antigen relapse-free survival (PSA-RFS) is a key outcome measure for localized prostate cancer.
• Combined risk profiles can enhance the prediction of PSA-RFS in patients undergoing treatment.
• Ultrasound-guided transperineal interstitial permanent prostate brachytherapy (TIPPB) is a treatment modality for localized prostate cancer.

Purpose of the Study:

• To report the 5-year biochemical outcome of a large cohort of patients treated with TIPPB.
• To evaluate the utility of prognostic factors and risk profiles in predicting PSA-RFS after TIPPB.
• To assess the 5-year PSA-RFS rates based on defined risk groups.

Main Methods:

• Retrospective analysis of 717 patients with localized prostate cancer treated with TIPPB between 1992 and 1997.
• Patients were stratified into favorable, intermediate, and unfavorable risk profiles based on pretreatment PSA and Gleason score.
• PSA-RFS was calculated using the ASTRO consensus definition; median follow-up was 41 months.

Main Results:

• The overall 5-year actuarial PSA-RFS was 82%.
• Multivariate analysis identified PSA and Gleason score as significant predictors of biochemical outcome.
• Favorable-risk patients achieved a 93% 5-year PSA-RFS, compared to 77% for intermediate-risk and 62% for unfavorable-risk patients.

Conclusions:

• TIPPB demonstrated excellent 5-year PSA-RFS rates in this large patient cohort.
• Risk profiles, derived from multivariate analysis of prognostic factors, effectively identify expected PSA-RFS for patients undergoing TIPPB.
• The study confirms the value of risk stratification for predicting outcomes in prostate brachytherapy.