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Related Experiment Videos

Optimizing patient selection for prostate monotherapy.

A K Lee1, D Schultz, A A Renshaw

  • 1Joint Center for Radiation Therapy, Harvard Medical School, 330 Brookline Avenue, 5th Floor, Boston, MA 02215, USA. alee@jcrt.harvard.edu

International Journal of Radiation Oncology, Biology, Physics
|February 15, 2001
PubMed
Summary
This summary is machine-generated.

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For low-risk prostate cancer patients, a high percentage of positive biopsy cores (>50%) predicts a worse outcome after surgery. This finding helps select patients for prostate-only radiation therapy.

Area of Science:

  • Urology
  • Oncology
  • Pathology

Background:

  • Low-risk prostate cancer is defined by specific PSA, Gleason Score, and AJCC clinical stage criteria.
  • Radical prostatectomy (RP) in low-risk patients can lead to less favorable PSA outcomes if Gleason score is upgraded post-surgery.
  • Optimizing treatment selection for these patients is crucial for improving outcomes.

Purpose of the Study:

  • To determine if the percentage of positive prostate biopsy cores can predict Gleason score upgrading in low-risk patients.
  • To identify factors that help optimize treatment selection for prostate-only radiation therapy.

Main Methods:

  • A study of 427 prostate cancer patients treated with radical prostatectomy was conducted.
  • Logistic regression analysis assessed prognostic factors and percentage of positive biopsies (<34%, 34-50%, >50%) for predicting Gleason score upgrading.

Related Experiment Videos

  • PSA failure-free survival was analyzed using Kaplan-Meier and log-rank tests.

    • Main Results:

    • Twenty-nine percent of patients were upgraded from biopsy Gleason score ≤6 to prostatectomy Gleason score ≥3+4.
    • Greater than 50% positive biopsies significantly predicted upgrading (59% vs. 26% for ≤50% positive biopsies).
    • Five-year PSA failure-free survival was significantly lower in patients with >50% positive biopsies (62% vs. 92% for ≤50% positive biopsies).

    Conclusions:

    • A high percentage of positive prostate biopsies (>50%) is associated with higher rates of pathologic upgrading.
    • This upgrading translates to significantly lower 5-year PSA failure-free survival after radical prostatectomy.
    • The percentage of positive biopsies can aid in selecting low-risk patients for prostate-only radiation therapy.