Salvage radical prostatectomy for radiation-recurrent prostate cancer: A multi-institutional collaboration

Daher C. Chade, Shahrokh F. Shariat, Angel M. Cronin, Caroline J. Savage, Robert Jeffrey Karnes, Michael L. Blute, Alberto Briganti, Francesco Montorsi, Henk G. Van Der Poel, Hendrik Van Poppel, Steven Joniau, Guilherme Godoy, Antonio Hurtado-Coll, Martin E. Gleave, Marcos Dall'Oglio, Miguel Srougi, Peter T. Scardino, James A. Eastham

Research output: Contribution to journalArticle

119 Citations (Scopus)

Abstract

Background: Oncologic outcomes in men with radiation-recurrent prostate cancer (PCa) treated with salvage radical prostatectomy (SRP) are poorly defined. Objective: To identify predictors of biochemical recurrence (BCR), metastasis, and death following SRP to help select patients who may benefit from SRP. Design, setting, and participants: This is a retrospective, international, multi-institutional cohort analysis. There was a median follow-up of 4.4 yr following SRP performed on 404 men with radiation-recurrent PCa from 1985 to 2009 in tertiary centers. Intervention: Open SRP. Measurements: BCR after SRP was defined as a serum prostate-specific antigen (PSA) ≥0.1 or ≥0.2 ng/ml (depending on the institution). Secondary end points included progression to metastasis and cancer-specific death. Results and limitations: Median age at SRP was 65 yr of age, and median pre-SRP PSA was 4.5 ng/ml. Following SRP, 195 patients experienced BCR, 64 developed metastases, and 40 died from PCa. At 10 yr after SRP, BCR-free survival, metastasis-free survival, and cancer-specific survival (CSS) probabilities were 37% (95% confidence interval [CI], 31-43), 77% (95% CI, 71-82), and 83% (95% CI, 76-88), respectively. On preoperative multivariable analysis, pre-SRP PSA and Gleason score at postradiation prostate biopsy predicted BCR (p = 0.022; global p < 0.001) and metastasis (p = 0.022; global p < 0.001). On postoperative multivariable analysis, pre-SRP PSA and pathologic Gleason score at SRP predicted BCR (p = 0.014; global p < 0.001) and metastasis (p < 0.001; global p < 0.001). Lymph node involvement (LNI) also predicted metastasis (p = 0.017). The main limitations of this study are its retrospective design and the follow-up period. Conclusions: In a select group of patients who underwent SRP for radiation-recurrent PCa, freedom from clinical metastasis was observed in >75% of patients 10 yr after surgery. Patients with lower pre-SRP PSA levels and lower postradiation prostate biopsy Gleason score have the highest probability of cure from SRP.

Original languageEnglish (US)
Pages (from-to)205-210
Number of pages6
JournalEuropean Urology
Volume60
Issue number2
DOIs
StatePublished - Aug 2011

Fingerprint

Prostatectomy
Prostatic Neoplasms
Radiation
Prostate-Specific Antigen
Recurrence
Neoplasm Metastasis
Neoplasm Grading
Confidence Intervals
Survival
Prostate
Biopsy
Neoplasms
Cohort Studies

Keywords

  • Prostate cancer
  • Radiation therapy
  • Salvage therapy

ASJC Scopus subject areas

  • Urology

Cite this

Chade, D. C., Shariat, S. F., Cronin, A. M., Savage, C. J., Karnes, R. J., Blute, M. L., ... Eastham, J. A. (2011). Salvage radical prostatectomy for radiation-recurrent prostate cancer: A multi-institutional collaboration. European Urology, 60(2), 205-210. https://doi.org/10.1016/j.eururo.2011.03.011

Salvage radical prostatectomy for radiation-recurrent prostate cancer : A multi-institutional collaboration. / Chade, Daher C.; Shariat, Shahrokh F.; Cronin, Angel M.; Savage, Caroline J.; Karnes, Robert Jeffrey; Blute, Michael L.; Briganti, Alberto; Montorsi, Francesco; Van Der Poel, Henk G.; Van Poppel, Hendrik; Joniau, Steven; Godoy, Guilherme; Hurtado-Coll, Antonio; Gleave, Martin E.; Dall'Oglio, Marcos; Srougi, Miguel; Scardino, Peter T.; Eastham, James A.

In: European Urology, Vol. 60, No. 2, 08.2011, p. 205-210.

Research output: Contribution to journalArticle

Chade, DC, Shariat, SF, Cronin, AM, Savage, CJ, Karnes, RJ, Blute, ML, Briganti, A, Montorsi, F, Van Der Poel, HG, Van Poppel, H, Joniau, S, Godoy, G, Hurtado-Coll, A, Gleave, ME, Dall'Oglio, M, Srougi, M, Scardino, PT & Eastham, JA 2011, 'Salvage radical prostatectomy for radiation-recurrent prostate cancer: A multi-institutional collaboration', European Urology, vol. 60, no. 2, pp. 205-210. https://doi.org/10.1016/j.eururo.2011.03.011
Chade, Daher C. ; Shariat, Shahrokh F. ; Cronin, Angel M. ; Savage, Caroline J. ; Karnes, Robert Jeffrey ; Blute, Michael L. ; Briganti, Alberto ; Montorsi, Francesco ; Van Der Poel, Henk G. ; Van Poppel, Hendrik ; Joniau, Steven ; Godoy, Guilherme ; Hurtado-Coll, Antonio ; Gleave, Martin E. ; Dall'Oglio, Marcos ; Srougi, Miguel ; Scardino, Peter T. ; Eastham, James A. / Salvage radical prostatectomy for radiation-recurrent prostate cancer : A multi-institutional collaboration. In: European Urology. 2011 ; Vol. 60, No. 2. pp. 205-210.
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title = "Salvage radical prostatectomy for radiation-recurrent prostate cancer: A multi-institutional collaboration",
abstract = "Background: Oncologic outcomes in men with radiation-recurrent prostate cancer (PCa) treated with salvage radical prostatectomy (SRP) are poorly defined. Objective: To identify predictors of biochemical recurrence (BCR), metastasis, and death following SRP to help select patients who may benefit from SRP. Design, setting, and participants: This is a retrospective, international, multi-institutional cohort analysis. There was a median follow-up of 4.4 yr following SRP performed on 404 men with radiation-recurrent PCa from 1985 to 2009 in tertiary centers. Intervention: Open SRP. Measurements: BCR after SRP was defined as a serum prostate-specific antigen (PSA) ≥0.1 or ≥0.2 ng/ml (depending on the institution). Secondary end points included progression to metastasis and cancer-specific death. Results and limitations: Median age at SRP was 65 yr of age, and median pre-SRP PSA was 4.5 ng/ml. Following SRP, 195 patients experienced BCR, 64 developed metastases, and 40 died from PCa. At 10 yr after SRP, BCR-free survival, metastasis-free survival, and cancer-specific survival (CSS) probabilities were 37{\%} (95{\%} confidence interval [CI], 31-43), 77{\%} (95{\%} CI, 71-82), and 83{\%} (95{\%} CI, 76-88), respectively. On preoperative multivariable analysis, pre-SRP PSA and Gleason score at postradiation prostate biopsy predicted BCR (p = 0.022; global p < 0.001) and metastasis (p = 0.022; global p < 0.001). On postoperative multivariable analysis, pre-SRP PSA and pathologic Gleason score at SRP predicted BCR (p = 0.014; global p < 0.001) and metastasis (p < 0.001; global p < 0.001). Lymph node involvement (LNI) also predicted metastasis (p = 0.017). The main limitations of this study are its retrospective design and the follow-up period. Conclusions: In a select group of patients who underwent SRP for radiation-recurrent PCa, freedom from clinical metastasis was observed in >75{\%} of patients 10 yr after surgery. Patients with lower pre-SRP PSA levels and lower postradiation prostate biopsy Gleason score have the highest probability of cure from SRP.",
keywords = "Prostate cancer, Radiation therapy, Salvage therapy",
author = "Chade, {Daher C.} and Shariat, {Shahrokh F.} and Cronin, {Angel M.} and Savage, {Caroline J.} and Karnes, {Robert Jeffrey} and Blute, {Michael L.} and Alberto Briganti and Francesco Montorsi and {Van Der Poel}, {Henk G.} and {Van Poppel}, Hendrik and Steven Joniau and Guilherme Godoy and Antonio Hurtado-Coll and Gleave, {Martin E.} and Marcos Dall'Oglio and Miguel Srougi and Scardino, {Peter T.} and Eastham, {James A.}",
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TY - JOUR

T1 - Salvage radical prostatectomy for radiation-recurrent prostate cancer

T2 - A multi-institutional collaboration

AU - Chade, Daher C.

AU - Shariat, Shahrokh F.

AU - Cronin, Angel M.

AU - Savage, Caroline J.

AU - Karnes, Robert Jeffrey

AU - Blute, Michael L.

AU - Briganti, Alberto

AU - Montorsi, Francesco

AU - Van Der Poel, Henk G.

AU - Van Poppel, Hendrik

AU - Joniau, Steven

AU - Godoy, Guilherme

AU - Hurtado-Coll, Antonio

AU - Gleave, Martin E.

AU - Dall'Oglio, Marcos

AU - Srougi, Miguel

AU - Scardino, Peter T.

AU - Eastham, James A.

PY - 2011/8

Y1 - 2011/8

N2 - Background: Oncologic outcomes in men with radiation-recurrent prostate cancer (PCa) treated with salvage radical prostatectomy (SRP) are poorly defined. Objective: To identify predictors of biochemical recurrence (BCR), metastasis, and death following SRP to help select patients who may benefit from SRP. Design, setting, and participants: This is a retrospective, international, multi-institutional cohort analysis. There was a median follow-up of 4.4 yr following SRP performed on 404 men with radiation-recurrent PCa from 1985 to 2009 in tertiary centers. Intervention: Open SRP. Measurements: BCR after SRP was defined as a serum prostate-specific antigen (PSA) ≥0.1 or ≥0.2 ng/ml (depending on the institution). Secondary end points included progression to metastasis and cancer-specific death. Results and limitations: Median age at SRP was 65 yr of age, and median pre-SRP PSA was 4.5 ng/ml. Following SRP, 195 patients experienced BCR, 64 developed metastases, and 40 died from PCa. At 10 yr after SRP, BCR-free survival, metastasis-free survival, and cancer-specific survival (CSS) probabilities were 37% (95% confidence interval [CI], 31-43), 77% (95% CI, 71-82), and 83% (95% CI, 76-88), respectively. On preoperative multivariable analysis, pre-SRP PSA and Gleason score at postradiation prostate biopsy predicted BCR (p = 0.022; global p < 0.001) and metastasis (p = 0.022; global p < 0.001). On postoperative multivariable analysis, pre-SRP PSA and pathologic Gleason score at SRP predicted BCR (p = 0.014; global p < 0.001) and metastasis (p < 0.001; global p < 0.001). Lymph node involvement (LNI) also predicted metastasis (p = 0.017). The main limitations of this study are its retrospective design and the follow-up period. Conclusions: In a select group of patients who underwent SRP for radiation-recurrent PCa, freedom from clinical metastasis was observed in >75% of patients 10 yr after surgery. Patients with lower pre-SRP PSA levels and lower postradiation prostate biopsy Gleason score have the highest probability of cure from SRP.

AB - Background: Oncologic outcomes in men with radiation-recurrent prostate cancer (PCa) treated with salvage radical prostatectomy (SRP) are poorly defined. Objective: To identify predictors of biochemical recurrence (BCR), metastasis, and death following SRP to help select patients who may benefit from SRP. Design, setting, and participants: This is a retrospective, international, multi-institutional cohort analysis. There was a median follow-up of 4.4 yr following SRP performed on 404 men with radiation-recurrent PCa from 1985 to 2009 in tertiary centers. Intervention: Open SRP. Measurements: BCR after SRP was defined as a serum prostate-specific antigen (PSA) ≥0.1 or ≥0.2 ng/ml (depending on the institution). Secondary end points included progression to metastasis and cancer-specific death. Results and limitations: Median age at SRP was 65 yr of age, and median pre-SRP PSA was 4.5 ng/ml. Following SRP, 195 patients experienced BCR, 64 developed metastases, and 40 died from PCa. At 10 yr after SRP, BCR-free survival, metastasis-free survival, and cancer-specific survival (CSS) probabilities were 37% (95% confidence interval [CI], 31-43), 77% (95% CI, 71-82), and 83% (95% CI, 76-88), respectively. On preoperative multivariable analysis, pre-SRP PSA and Gleason score at postradiation prostate biopsy predicted BCR (p = 0.022; global p < 0.001) and metastasis (p = 0.022; global p < 0.001). On postoperative multivariable analysis, pre-SRP PSA and pathologic Gleason score at SRP predicted BCR (p = 0.014; global p < 0.001) and metastasis (p < 0.001; global p < 0.001). Lymph node involvement (LNI) also predicted metastasis (p = 0.017). The main limitations of this study are its retrospective design and the follow-up period. Conclusions: In a select group of patients who underwent SRP for radiation-recurrent PCa, freedom from clinical metastasis was observed in >75% of patients 10 yr after surgery. Patients with lower pre-SRP PSA levels and lower postradiation prostate biopsy Gleason score have the highest probability of cure from SRP.

KW - Prostate cancer

KW - Radiation therapy

KW - Salvage therapy

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