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Predictors of survival for prostate carcinoma patients treated with salvage radical prostatectomy after radiation therapy
Author(s) -
Cheng Liang,
Sebo Thomas J.,
Slezak Jeff,
Pisansky Thomas M.,
Bergstralh Erik J.,
Neumann Roxann M.,
Iczkowski Kenneth A.,
Zincke Horst,
Bostwick David G.
Publication year - 1998
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19981115)83:10<2164::aid-cncr15>3.0.co;2-i
Subject(s) - medicine , prostatectomy , prostate cancer , salvage therapy , radiation therapy , surgery , survival rate , metastasis , proportional hazards model , biochemical recurrence , carcinoma , cancer , urology , oncology , chemotherapy
BACKGROUND Salvage radical prostatectomy is a treatment option for patients with recurrent cancer following radiation therapy. This study was conducted to identify predictors of survival for patients treated with salvage radical prostatectomy. METHODS The authors studied 86 prostate carcinoma patients who underwent salvage radical prostatectomy for locally persistent or recurrent prostate carcinoma at Mayo Clinic between 1967 and 1996. The mean interval from radiation therapy to biopsy‐proven recurrence was 3.7 years (range, 6 months to 17 years). Patient age at surgery ranged from 51 to 78 years (median, 66 years). The mean follow‐up after surgery was 5.8 years (range, 1.0‐15.2 years). Cox proportional hazards models were used to identify clinical and pathologic factors associated with distant metastasis free survival and cancer specific survival. RESULTS Actuarial distant metastasis free survival, cancer specific survival, and overall survival were 83%, 91%, and 85% at 5 years and 69%, 64%, and 54% at 10 years, respectively. In multivariate analysis, radical prostatectomy Gleason score and DNA ploidy were independent predictors of distant metastasis free survival and cancer specific survival. CONCLUSIONS Postirradiation Gleason score and DNA ploidy were highly predictive of the clinical outcomes of patients treated by salvage radical prostatectomy after radiation therapy. Cancer 1998;83:2164‐2171. © 1998 American Cancer Society.