The prostate cancer risk stratification project: database construction and risk stratification outcome analysis

Area of Science:

• Oncology
• Radiation Oncology
• Biostatistics

Background:

• The Genitourinary Radiation Oncologists of Canada (GUROC) developed the Prostate Cancer Risk Stratification (ProCaRS) database.
• The database consolidates data from 7 unique sources, comprising 7974 patients who received radiotherapy.

Purpose of the Study:

• To report on the biochemical and clinical outcomes of prostate cancer patients within the ProCaRS database.
• To identify predictors of treatment success and evaluate risk stratification systems for prostate cancer radiotherapy.

Main Methods:

• Descriptive analysis, Cox proportional hazards, and Kaplan-Meier analyses were employed.
• Outcomes analyzed included American Society for Radiation Oncology (ASTRO) biochemical failure-free survival (BFFS), prostate cancer-specific survival, and overall survival.
• Multivariable modeling was used to identify predictive factors for BFFS.

Main Results:

• Age, prostate-specific antigen (PSA) levels, T stage, and Gleason score were significant predictors of outcome.
• Hormonal therapy and radiation treatment modality (brachytherapy demonstrated superior outcomes to external-beam radiation) influenced patient results.
• Kaplan-Meier analysis confirmed good separation of clinical outcome curves using both the GUROC and National Comprehensive Cancer Network (NCCN) classification systems.

Conclusions:

• The pan-Canadian ProCaRS database provides valuable insights into prostate cancer radiotherapy outcomes.
• Established clinical factors and treatment modalities are crucial for risk stratification in prostate cancer radiotherapy.
• The ProCaRS database supports improved risk stratification and informs clinical decision-making for prostate cancer patients undergoing radiotherapy.