Relationship between prostate volume, prostate-specific antigen nadir, and biochemical control.

Area of Science:

• Urology
• Radiation Oncology
• Oncology

Background:

• Localized prostate adenocarcinoma is often treated with definitive three-dimensional conformal radiotherapy (3D-CRT).
• Predicting treatment outcomes, such as biochemical control (bNED), is crucial for patient management.
• Prostate gland volume is a potential factor influencing treatment response.

Purpose of the Study:

• To evaluate the relationship between pretreatment prostate gland volume and posttreatment prostate-specific antigen (PSA) nadir.
• To assess the association of prostate volume and PSA nadir with biochemical control (bNED).
• To analyze these relationships in both favorable and unfavorable risk subgroups.

Main Methods:

• Retrospective analysis of 655 men treated with 3D-CRT for localized prostate adenocarcinoma.
• Data collected included pretreatment prostate volume, PSA, Gleason score, T stage, and posttreatment PSA nadir.
• Patients were stratified into favorable and unfavorable subgroups, with a minimum follow-up of 24 months.

Main Results:

• Prostate volume was a significant predictor of PSA nadir in both favorable and unfavorable subgroups (p <0.0001).
• PSA nadir was predictive of bNED in the unfavorable group but not the favorable group.
• Prostate volume predicted bNED failure in the favorable group but not the unfavorable group.

Conclusions:

• Prostate gland volume is a significant predictor of PSA nadir in patients achieving biochemical control (bNED) after 3D-CRT.
• PSA nadir is a strong predictor of bNED in unfavorable risk prostate cancer patients.
• Prostate volume influences bNED outcomes, particularly in favorable risk patients.