Related Experiment Video
Updated: Jun 25, 2025
13:19
Microarray-based Identification of Individual HERV Loci Expression: Application to Biomarker Discovery in Prostate Cancer
Published on: November 2, 2013
16.6K
Refining Risk Stratification of High-risk and Locoregional Prostate Cancer: A Pooled Analysis of Randomized Trials
Praful Ravi1, Wanling Xie1, Marc Buyse2
1Dana-Farber Cancer Institute, Boston, MA, USA.
European Urology
|May 22, 2024
Summary
Patients with high-risk localized prostate cancer receiving radiotherapy and long-term androgen deprivation therapy have poorer outcomes if they have multiple risk factors or lymph node involvement. These findings help identify patients who may benefit from intensified treatment strategies.
Area of Science:
- Oncology
- Radiation Oncology
- Urology
Background:
- Radiotherapy (RT) plus long-term androgen deprivation therapy (ltADT) is standard for high-risk localized/locoregional prostate cancer (HRLPC).
- Identifying patients with poorer prognosis on standard therapy is crucial for treatment optimization.
Purpose of the Study:
- To evaluate outcomes in HRLPC patients treated with RT + ltADT.
- To identify specific risk factors associated with poorer prognosis in this patient group.
Main Methods:
- Individual patient data from ten randomized controlled trials were analyzed.
- Prognostic factors included Gleason score ≥8, cT3-4, prostate-specific antigen (PSA) >20 ng/ml, and cN1 disease.
- Metastasis-free survival (MFS), overall survival (OS), and other outcomes were assessed using multivariable regression.
Main Results:
- Gleason score ≥8, cN1 disease, cT3-4, and PSA >20 ng/ml were all associated with poorer MFS and OS.
- Patients with two to three risk factors (RFs) had significantly lower 10-year MFS (53%) and OS (60%) compared to those with one RF.
- Patients with cN1 disease had particularly poor outcomes, with 10-year MFS of 36% and OS of 47%.
Conclusions:
- HRLPC patients with two to three risk factors (cN0) or cN1 disease experience the poorest outcomes with standard RT and ltADT.
- These findings aid in patient counseling and can guide the design of adjuvant clinical trials for HRLPC.
- Patients with multiple risk factors or lymph node involvement may be candidates for treatment intensification.
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