Contemporary Update of a Multi-Institutional Predictive Nomogram for Salvage Radiotherapy After Radical Prostatectomy

Rahul D Tendulkar; Shree Agrawal; Tianming Gao; Jason A Efstathiou; Thomas M Pisansky; Jeff M Michalski; Bridget F Koontz; Daniel A Hamstra; Felix Y Feng; Stanley L Liauw; Matthew C Abramowitz; Alan Pollack; Mitchell S Anscher; Drew Moghanaki; Robert B Den; Kevin L Stephans; Anthony L Zietman; W. Robert Lee; Michael W Kattan; Andrew J Stephenson

doi:10.1200/JCO.2016.67.9647

Back

Contemporary Update of a Multi-Institutional Predictive Nomogram for Salvage Radiotherapy After Radical Prostatectomy

Journal article

Peer reviewed

Contemporary Update of a Multi-Institutional Predictive Nomogram for Salvage Radiotherapy After Radical Prostatectomy

Rahul D Tendulkar, Shree Agrawal, Tianming Gao, Jason A Efstathiou, Thomas M Pisansky, Jeff M Michalski, Bridget F Koontz, Daniel A Hamstra, Felix Y Feng, Stanley L Liauw, …

Journal of clinical oncology, Vol.34(30), pp.3648-3654

2016-10-20

DOI: https://doi.org/10.1200/JCO.2016.67.9647

PMID: 27528718

Abstract

Purpose We aimed to update a previously published, multi-institutional nomogram of outcomes for salvage radiotherapy (SRT) following radical prostatectomy (RP) for prostate cancer, including patients treated in the contemporary era. Methods Individual data from node-negative patients with a detectable post-RP prostate-specific antigen (PSA) treated with SRT with or without concurrent androgen-deprivation therapy (ADT) were obtained from 10 academic institutions. Freedom from biochemical failure (FFBF) and distant metastases (DM) rates were estimated, and predictive nomograms were generated. Results Overall, 2,460 patients with a median follow-up of 5 years were included; 599 patients (24%) had a Gleason score (GS) ≤ 6, 1,387 (56%) had a GS of 7, 244 (10%) had a GS of 8, and 230 (9%) had a GS of 9 to 10. There were 1,370 patients (56%) with extraprostatic extension (EPE), 452 (18%) with seminal vesicle invasion (SVI), 1,434 (58%) with positive surgical margins, and 390 (16%) who received ADT (median, 6 months). The median pre-SRT PSA was 0.5 ng/mL (interquartile range, 0.3 to 1.1). The 5-yr FFBF rate was 56% overall, 71% for those with a pre-SRT PSA level of 0.01 to 0.2 ng/mL (n = 441), 63% for those with a PSA of 0.21 to 0.50 ng/mL (n = 822), 54% for those with a PSA of 0.51 to 1.0 ng/mL (n = 533), 43% for those with a PSA of 1.01 to 2.0 ng/mL (n = 341), and 37% for those with a PSA > 2.0 ng/mL (n = 323); P < .001. On multivariable analysis, pre-SRT PSA, GS, EPE, SVI, surgical margins, ADT use, and SRT dose were associated with FFBF. Pre-SRT PSA, GS, SVI, surgical margins, and ADT use were associated with DM, whereas EPE and SRT dose were not. The nomogram concordance indices were 0.68 (FFBF) and 0.74 (DM). Conclusion Early SRT at low PSA levels after RP is associated with improved FFBF and DM rates. Contemporary nomograms can estimate individual patient outcomes after SRT in the modern era.

Metrics

239 Record Views

262 Times Cited - Web of Science

See more details

InCites Highlights

These are selected metrics from InCites Benchmarking & Analytics tool, related to this output

Highly Cited Paper

Collaboration types: Domestic collaboration
Citation topics: 1 Clinical & Life Sciences; 1.147 Prostate Cancer; 1.147.97 Prostate Cancer
Web Of Science research areas: Oncology
ESI research areas: Clinical Medicine

UN Sustainable Development Goals (SDGs)

This output has contributed to the advancement of the following goals:

Source: InCites

Details

Title: Contemporary Update of a Multi-Institutional Predictive Nomogram for Salvage Radiotherapy After Radical Prostatectomy
Creators: Rahul D Tendulkar - Rahul D. Tendulkar, Tianming Gao, Kevin L. Stephans, Michael W. Kattan, and Andrew J. Stephenson, Cleveland Clinic; Shree Agrawal, Case Western Reserve University School of Medicine, Cleveland, OH; Jason A. Efstathiou and Anthony L. Zietman, Massachusetts General Hospital, Boston, MA; Thomas M. Pisansky, Mayo Clinic, Rochester, MN; Jeff M. Michalski, Washington University, St Louis, MO; Bridget F. Koontz and W. Robert Lee, Duke University, Durham, NC; Daniel A. Hamstra, The Texas Center for Proton
Shree Agrawal - Rahul D. Tendulkar, Tianming Gao, Kevin L. Stephans, Michael W. Kattan, and Andrew J. Stephenson, Cleveland Clinic; Shree Agrawal, Case Western Reserve University School of Medicine, Cleveland, OH; Jason A. Efstathiou and Anthony L. Zietman, Massachusetts General Hospital, Boston, MA; Thomas M. Pisansky, Mayo Clinic, Rochester, MN; Jeff M. Michalski, Washington University, St Louis, MO; Bridget F. Koontz and W. Robert Lee, Duke University, Durham, NC; Daniel A. Hamstra, The Texas Center for Proton
Tianming Gao - Rahul D. Tendulkar, Tianming Gao, Kevin L. Stephans, Michael W. Kattan, and Andrew J. Stephenson, Cleveland Clinic; Shree Agrawal, Case Western Reserve University School of Medicine, Cleveland, OH; Jason A. Efstathiou and Anthony L. Zietman, Massachusetts General Hospital, Boston, MA; Thomas M. Pisansky, Mayo Clinic, Rochester, MN; Jeff M. Michalski, Washington University, St Louis, MO; Bridget F. Koontz and W. Robert Lee, Duke University, Durham, NC; Daniel A. Hamstra, The Texas Center for Proton
Jason A Efstathiou - Rahul D. Tendulkar, Tianming Gao, Kevin L. Stephans, Michael W. Kattan, and Andrew J. Stephenson, Cleveland Clinic; Shree Agrawal, Case Western Reserve University School of Medicine, Cleveland, OH; Jason A. Efstathiou and Anthony L. Zietman, Massachusetts General Hospital, Boston, MA; Thomas M. Pisansky, Mayo Clinic, Rochester, MN; Jeff M. Michalski, Washington University, St Louis, MO; Bridget F. Koontz and W. Robert Lee, Duke University, Durham, NC; Daniel A. Hamstra, The Texas Center for Proton
Thomas M Pisansky - Rahul D. Tendulkar, Tianming Gao, Kevin L. Stephans, Michael W. Kattan, and Andrew J. Stephenson, Cleveland Clinic; Shree Agrawal, Case Western Reserve University School of Medicine, Cleveland, OH; Jason A. Efstathiou and Anthony L. Zietman, Massachusetts General Hospital, Boston, MA; Thomas M. Pisansky, Mayo Clinic, Rochester, MN; Jeff M. Michalski, Washington University, St Louis, MO; Bridget F. Koontz and W. Robert Lee, Duke University, Durham, NC; Daniel A. Hamstra, The Texas Center for Proton
Jeff M Michalski - Rahul D. Tendulkar, Tianming Gao, Kevin L. Stephans, Michael W. Kattan, and Andrew J. Stephenson, Cleveland Clinic; Shree Agrawal, Case Western Reserve University School of Medicine, Cleveland, OH; Jason A. Efstathiou and Anthony L. Zietman, Massachusetts General Hospital, Boston, MA; Thomas M. Pisansky, Mayo Clinic, Rochester, MN; Jeff M. Michalski, Washington University, St Louis, MO; Bridget F. Koontz and W. Robert Lee, Duke University, Durham, NC; Daniel A. Hamstra, The Texas Center for Proton
Bridget F Koontz - Rahul D. Tendulkar, Tianming Gao, Kevin L. Stephans, Michael W. Kattan, and Andrew J. Stephenson, Cleveland Clinic; Shree Agrawal, Case Western Reserve University School of Medicine, Cleveland, OH; Jason A. Efstathiou and Anthony L. Zietman, Massachusetts General Hospital, Boston, MA; Thomas M. Pisansky, Mayo Clinic, Rochester, MN; Jeff M. Michalski, Washington University, St Louis, MO; Bridget F. Koontz and W. Robert Lee, Duke University, Durham, NC; Daniel A. Hamstra, The Texas Center for Proton
Daniel A Hamstra - Rahul D. Tendulkar, Tianming Gao, Kevin L. Stephans, Michael W. Kattan, and Andrew J. Stephenson, Cleveland Clinic; Shree Agrawal, Case Western Reserve University School of Medicine, Cleveland, OH; Jason A. Efstathiou and Anthony L. Zietman, Massachusetts General Hospital, Boston, MA; Thomas M. Pisansky, Mayo Clinic, Rochester, MN; Jeff M. Michalski, Washington University, St Louis, MO; Bridget F. Koontz and W. Robert Lee, Duke University, Durham, NC; Daniel A. Hamstra, The Texas Center for Proton
Felix Y Feng - Rahul D. Tendulkar, Tianming Gao, Kevin L. Stephans, Michael W. Kattan, and Andrew J. Stephenson, Cleveland Clinic; Shree Agrawal, Case Western Reserve University School of Medicine, Cleveland, OH; Jason A. Efstathiou and Anthony L. Zietman, Massachusetts General Hospital, Boston, MA; Thomas M. Pisansky, Mayo Clinic, Rochester, MN; Jeff M. Michalski, Washington University, St Louis, MO; Bridget F. Koontz and W. Robert Lee, Duke University, Durham, NC; Daniel A. Hamstra, The Texas Center for Proton
Stanley L Liauw - Rahul D. Tendulkar, Tianming Gao, Kevin L. Stephans, Michael W. Kattan, and Andrew J. Stephenson, Cleveland Clinic; Shree Agrawal, Case Western Reserve University School of Medicine, Cleveland, OH; Jason A. Efstathiou and Anthony L. Zietman, Massachusetts General Hospital, Boston, MA; Thomas M. Pisansky, Mayo Clinic, Rochester, MN; Jeff M. Michalski, Washington University, St Louis, MO; Bridget F. Koontz and W. Robert Lee, Duke University, Durham, NC; Daniel A. Hamstra, The Texas Center for Proton
Matthew C Abramowitz - Rahul D. Tendulkar, Tianming Gao, Kevin L. Stephans, Michael W. Kattan, and Andrew J. Stephenson, Cleveland Clinic; Shree Agrawal, Case Western Reserve University School of Medicine, Cleveland, OH; Jason A. Efstathiou and Anthony L. Zietman, Massachusetts General Hospital, Boston, MA; Thomas M. Pisansky, Mayo Clinic, Rochester, MN; Jeff M. Michalski, Washington University, St Louis, MO; Bridget F. Koontz and W. Robert Lee, Duke University, Durham, NC; Daniel A. Hamstra, The Texas Center for Proton
Alan Pollack - Rahul D. Tendulkar, Tianming Gao, Kevin L. Stephans, Michael W. Kattan, and Andrew J. Stephenson, Cleveland Clinic; Shree Agrawal, Case Western Reserve University School of Medicine, Cleveland, OH; Jason A. Efstathiou and Anthony L. Zietman, Massachusetts General Hospital, Boston, MA; Thomas M. Pisansky, Mayo Clinic, Rochester, MN; Jeff M. Michalski, Washington University, St Louis, MO; Bridget F. Koontz and W. Robert Lee, Duke University, Durham, NC; Daniel A. Hamstra, The Texas Center for Proton
Mitchell S Anscher - Rahul D. Tendulkar, Tianming Gao, Kevin L. Stephans, Michael W. Kattan, and Andrew J. Stephenson, Cleveland Clinic; Shree Agrawal, Case Western Reserve University School of Medicine, Cleveland, OH; Jason A. Efstathiou and Anthony L. Zietman, Massachusetts General Hospital, Boston, MA; Thomas M. Pisansky, Mayo Clinic, Rochester, MN; Jeff M. Michalski, Washington University, St Louis, MO; Bridget F. Koontz and W. Robert Lee, Duke University, Durham, NC; Daniel A. Hamstra, The Texas Center for Proton
Drew Moghanaki - Rahul D. Tendulkar, Tianming Gao, Kevin L. Stephans, Michael W. Kattan, and Andrew J. Stephenson, Cleveland Clinic; Shree Agrawal, Case Western Reserve University School of Medicine, Cleveland, OH; Jason A. Efstathiou and Anthony L. Zietman, Massachusetts General Hospital, Boston, MA; Thomas M. Pisansky, Mayo Clinic, Rochester, MN; Jeff M. Michalski, Washington University, St Louis, MO; Bridget F. Koontz and W. Robert Lee, Duke University, Durham, NC; Daniel A. Hamstra, The Texas Center for Proton
Robert B Den - Rahul D. Tendulkar, Tianming Gao, Kevin L. Stephans, Michael W. Kattan, and Andrew J. Stephenson, Cleveland Clinic; Shree Agrawal, Case Western Reserve University School of Medicine, Cleveland, OH; Jason A. Efstathiou and Anthony L. Zietman, Massachusetts General Hospital, Boston, MA; Thomas M. Pisansky, Mayo Clinic, Rochester, MN; Jeff M. Michalski, Washington University, St Louis, MO; Bridget F. Koontz and W. Robert Lee, Duke University, Durham, NC; Daniel A. Hamstra, The Texas Center for Proton
Kevin L Stephans - Rahul D. Tendulkar, Tianming Gao, Kevin L. Stephans, Michael W. Kattan, and Andrew J. Stephenson, Cleveland Clinic; Shree Agrawal, Case Western Reserve University School of Medicine, Cleveland, OH; Jason A. Efstathiou and Anthony L. Zietman, Massachusetts General Hospital, Boston, MA; Thomas M. Pisansky, Mayo Clinic, Rochester, MN; Jeff M. Michalski, Washington University, St Louis, MO; Bridget F. Koontz and W. Robert Lee, Duke University, Durham, NC; Daniel A. Hamstra, The Texas Center for Proton
Anthony L Zietman - Rahul D. Tendulkar, Tianming Gao, Kevin L. Stephans, Michael W. Kattan, and Andrew J. Stephenson, Cleveland Clinic; Shree Agrawal, Case Western Reserve University School of Medicine, Cleveland, OH; Jason A. Efstathiou and Anthony L. Zietman, Massachusetts General Hospital, Boston, MA; Thomas M. Pisansky, Mayo Clinic, Rochester, MN; Jeff M. Michalski, Washington University, St Louis, MO; Bridget F. Koontz and W. Robert Lee, Duke University, Durham, NC; Daniel A. Hamstra, The Texas Center for Proton
W. Robert Lee - Rahul D. Tendulkar, Tianming Gao, Kevin L. Stephans, Michael W. Kattan, and Andrew J. Stephenson, Cleveland Clinic; Shree Agrawal, Case Western Reserve University School of Medicine, Cleveland, OH; Jason A. Efstathiou and Anthony L. Zietman, Massachusetts General Hospital, Boston, MA; Thomas M. Pisansky, Mayo Clinic, Rochester, MN; Jeff M. Michalski, Washington University, St Louis, MO; Bridget F. Koontz and W. Robert Lee, Duke University, Durham, NC; Daniel A. Hamstra, The Texas Center for Proton
Michael W Kattan - Rahul D. Tendulkar, Tianming Gao, Kevin L. Stephans, Michael W. Kattan, and Andrew J. Stephenson, Cleveland Clinic; Shree Agrawal, Case Western Reserve University School of Medicine, Cleveland, OH; Jason A. Efstathiou and Anthony L. Zietman, Massachusetts General Hospital, Boston, MA; Thomas M. Pisansky, Mayo Clinic, Rochester, MN; Jeff M. Michalski, Washington University, St Louis, MO; Bridget F. Koontz and W. Robert Lee, Duke University, Durham, NC; Daniel A. Hamstra, The Texas Center for Proton
Andrew J Stephenson - Rahul D. Tendulkar, Tianming Gao, Kevin L. Stephans, Michael W. Kattan, and Andrew J. Stephenson, Cleveland Clinic; Shree Agrawal, Case Western Reserve University School of Medicine, Cleveland, OH; Jason A. Efstathiou and Anthony L. Zietman, Massachusetts General Hospital, Boston, MA; Thomas M. Pisansky, Mayo Clinic, Rochester, MN; Jeff M. Michalski, Washington University, St Louis, MO; Bridget F. Koontz and W. Robert Lee, Duke University, Durham, NC; Daniel A. Hamstra, The Texas Center for Proton
Publication Details: Journal of clinical oncology, Vol.34(30), pp.3648-3654
Academic Unit: Leadership Department; Miller School of Medicine; UMMG Dept of Radiation Oncology
Language: English
Resource Type: Journal article
PMID: 27528718
Record Identifier: 991031577452502976