Predicting the Outcome of Salvage Radiation Therapy for Recurrent Prostate Cancer After Radical Prostatectomy

Andrew J Stephenson; Peter T Scardino; Michael W Kattan; Thomas M Pisansky; Kevin M Slawin; Eric A Klein; Mitchell S Anscher; Jeff M Michalski; Howard M Sandler; Daniel W Lin; Jeffrey D Forman; Michael J Zelefsky; Larry L Kestin; Claus G Roehrborn; Charles N Catton; Theodore L DeWeese; Stanley L Liauw; Richard K Valicenti; Deborah A Kuban; Alan Pollack

doi:10.1200/JCO.2006.08.9607

Back

Predicting the Outcome of Salvage Radiation Therapy for Recurrent Prostate Cancer After Radical Prostatectomy

Journal article

Open access

Peer reviewed

Predicting the Outcome of Salvage Radiation Therapy for Recurrent Prostate Cancer After Radical Prostatectomy

Andrew J Stephenson, Peter T Scardino, Michael W Kattan, Thomas M Pisansky, Kevin M Slawin, Eric A Klein, Mitchell S Anscher, Jeff M Michalski, Howard M Sandler, Daniel W Lin, …

Journal of clinical oncology, Vol.25(15), pp.2035-2041

2007-05-20

DOI: https://doi.org/10.1200/JCO.2006.08.9607

PMCID: PMC2670394

PMID: 17513807

Abstract

Purpose An increasing serum prostate-specific antigen (PSA) level is the initial sign of recurrent prostate cancer among patients treated with radical prostatectomy. Salvage radiation therapy (SRT) may eradicate locally recurrent cancer, but studies to distinguish local from systemic recurrence lack adequate sensitivity and specificity. We developed a nomogram to predict the probability of cancer control at 6 years after SRT for PSA-defined recurrence. Patients and Methods Using multivariable Cox regression analysis, we constructed a model to predict the probability of disease progression after SRT in a multi-institutional cohort of 1,540 patients. Results The 6-year progression-free probability was 32% (95% CI, 28% to 35%) overall. Forty-eight percent (95% CI, 40% to 56%) of patients treated with SRT alone at PSA levels of 0.50 ng/mL or lower were disease free at 6 years, including 41% (95% CI, 31% to 51%) who also had a PSA doubling time of 10 months or less or poorly differentiated (Gleason grade 8 to 10) cancer. Significant variables in the model were PSA level before SRT (P < .001), prostatectomy Gleason grade (P < .001), PSA doubling time (P < .001), surgical margins (P < .001), androgen-deprivation therapy before or during SRT (P < .001), and lymph node metastasis (P = .019). The resultant nomogram was internally validated and had a concordance index of 0.69. Conclusion Nearly half of patients with recurrent prostate cancer after radical prostatectomy have a long-term PSA response to SRT when treatment is administered at the earliest sign of recurrence. The nomogram we developed predicts the outcome of SRT and should prove valuable for medical decision making for patients with a rising PSA level.

Files and links (1)

url

https://doi.org/10.1200/JCO.2006.08.9607View

Published (Version of record) Open

Metrics

26 Record Views

723 Times Cited - Web of Science

See more details

InCites Highlights

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

Collaboration types: Domestic collaboration; International 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: Predicting the Outcome of Salvage Radiation Therapy for Recurrent Prostate Cancer After Radical Prostatectomy
Creators: Andrew J Stephenson - From the Cleveland Clinic Foundation, Cleveland, OH; Memorial Sloan-Kettering Cancer Center, New York, NY; Mayo Clinic College of Medicine, Rochester, MN; Baylor College of Medicine; The University of Texas M.D. Anderson Cancer Center, Houston; The University of Texas Southwestern Medical Center, Dallas, TX; Duke University School of Medicine, Durham, NC; Washington University School of Medicine, St Louis, MO; University of Michigan Medical Center, Ann Arbor, MI; University of Washington School of
Peter T Scardino - From the Cleveland Clinic Foundation, Cleveland, OH; Memorial Sloan-Kettering Cancer Center, New York, NY; Mayo Clinic College of Medicine, Rochester, MN; Baylor College of Medicine; The University of Texas M.D. Anderson Cancer Center, Houston; The University of Texas Southwestern Medical Center, Dallas, TX; Duke University School of Medicine, Durham, NC; Washington University School of Medicine, St Louis, MO; University of Michigan Medical Center, Ann Arbor, MI; University of Washington School of
Michael W Kattan - From the Cleveland Clinic Foundation, Cleveland, OH; Memorial Sloan-Kettering Cancer Center, New York, NY; Mayo Clinic College of Medicine, Rochester, MN; Baylor College of Medicine; The University of Texas M.D. Anderson Cancer Center, Houston; The University of Texas Southwestern Medical Center, Dallas, TX; Duke University School of Medicine, Durham, NC; Washington University School of Medicine, St Louis, MO; University of Michigan Medical Center, Ann Arbor, MI; University of Washington School of
Thomas M Pisansky - From the Cleveland Clinic Foundation, Cleveland, OH; Memorial Sloan-Kettering Cancer Center, New York, NY; Mayo Clinic College of Medicine, Rochester, MN; Baylor College of Medicine; The University of Texas M.D. Anderson Cancer Center, Houston; The University of Texas Southwestern Medical Center, Dallas, TX; Duke University School of Medicine, Durham, NC; Washington University School of Medicine, St Louis, MO; University of Michigan Medical Center, Ann Arbor, MI; University of Washington School of
Kevin M Slawin - From the Cleveland Clinic Foundation, Cleveland, OH; Memorial Sloan-Kettering Cancer Center, New York, NY; Mayo Clinic College of Medicine, Rochester, MN; Baylor College of Medicine; The University of Texas M.D. Anderson Cancer Center, Houston; The University of Texas Southwestern Medical Center, Dallas, TX; Duke University School of Medicine, Durham, NC; Washington University School of Medicine, St Louis, MO; University of Michigan Medical Center, Ann Arbor, MI; University of Washington School of
Eric A Klein - From the Cleveland Clinic Foundation, Cleveland, OH; Memorial Sloan-Kettering Cancer Center, New York, NY; Mayo Clinic College of Medicine, Rochester, MN; Baylor College of Medicine; The University of Texas M.D. Anderson Cancer Center, Houston; The University of Texas Southwestern Medical Center, Dallas, TX; Duke University School of Medicine, Durham, NC; Washington University School of Medicine, St Louis, MO; University of Michigan Medical Center, Ann Arbor, MI; University of Washington School of
Mitchell S Anscher - From the Cleveland Clinic Foundation, Cleveland, OH; Memorial Sloan-Kettering Cancer Center, New York, NY; Mayo Clinic College of Medicine, Rochester, MN; Baylor College of Medicine; The University of Texas M.D. Anderson Cancer Center, Houston; The University of Texas Southwestern Medical Center, Dallas, TX; Duke University School of Medicine, Durham, NC; Washington University School of Medicine, St Louis, MO; University of Michigan Medical Center, Ann Arbor, MI; University of Washington School of
Jeff M Michalski - From the Cleveland Clinic Foundation, Cleveland, OH; Memorial Sloan-Kettering Cancer Center, New York, NY; Mayo Clinic College of Medicine, Rochester, MN; Baylor College of Medicine; The University of Texas M.D. Anderson Cancer Center, Houston; The University of Texas Southwestern Medical Center, Dallas, TX; Duke University School of Medicine, Durham, NC; Washington University School of Medicine, St Louis, MO; University of Michigan Medical Center, Ann Arbor, MI; University of Washington School of
Howard M Sandler - From the Cleveland Clinic Foundation, Cleveland, OH; Memorial Sloan-Kettering Cancer Center, New York, NY; Mayo Clinic College of Medicine, Rochester, MN; Baylor College of Medicine; The University of Texas M.D. Anderson Cancer Center, Houston; The University of Texas Southwestern Medical Center, Dallas, TX; Duke University School of Medicine, Durham, NC; Washington University School of Medicine, St Louis, MO; University of Michigan Medical Center, Ann Arbor, MI; University of Washington School of
Daniel W Lin - From the Cleveland Clinic Foundation, Cleveland, OH; Memorial Sloan-Kettering Cancer Center, New York, NY; Mayo Clinic College of Medicine, Rochester, MN; Baylor College of Medicine; The University of Texas M.D. Anderson Cancer Center, Houston; The University of Texas Southwestern Medical Center, Dallas, TX; Duke University School of Medicine, Durham, NC; Washington University School of Medicine, St Louis, MO; University of Michigan Medical Center, Ann Arbor, MI; University of Washington School of
Jeffrey D Forman - From the Cleveland Clinic Foundation, Cleveland, OH; Memorial Sloan-Kettering Cancer Center, New York, NY; Mayo Clinic College of Medicine, Rochester, MN; Baylor College of Medicine; The University of Texas M.D. Anderson Cancer Center, Houston; The University of Texas Southwestern Medical Center, Dallas, TX; Duke University School of Medicine, Durham, NC; Washington University School of Medicine, St Louis, MO; University of Michigan Medical Center, Ann Arbor, MI; University of Washington School of
Michael J Zelefsky - From the Cleveland Clinic Foundation, Cleveland, OH; Memorial Sloan-Kettering Cancer Center, New York, NY; Mayo Clinic College of Medicine, Rochester, MN; Baylor College of Medicine; The University of Texas M.D. Anderson Cancer Center, Houston; The University of Texas Southwestern Medical Center, Dallas, TX; Duke University School of Medicine, Durham, NC; Washington University School of Medicine, St Louis, MO; University of Michigan Medical Center, Ann Arbor, MI; University of Washington School of
Larry L Kestin - From the Cleveland Clinic Foundation, Cleveland, OH; Memorial Sloan-Kettering Cancer Center, New York, NY; Mayo Clinic College of Medicine, Rochester, MN; Baylor College of Medicine; The University of Texas M.D. Anderson Cancer Center, Houston; The University of Texas Southwestern Medical Center, Dallas, TX; Duke University School of Medicine, Durham, NC; Washington University School of Medicine, St Louis, MO; University of Michigan Medical Center, Ann Arbor, MI; University of Washington School of
Claus G Roehrborn - From the Cleveland Clinic Foundation, Cleveland, OH; Memorial Sloan-Kettering Cancer Center, New York, NY; Mayo Clinic College of Medicine, Rochester, MN; Baylor College of Medicine; The University of Texas M.D. Anderson Cancer Center, Houston; The University of Texas Southwestern Medical Center, Dallas, TX; Duke University School of Medicine, Durham, NC; Washington University School of Medicine, St Louis, MO; University of Michigan Medical Center, Ann Arbor, MI; University of Washington School of
Charles N Catton - From the Cleveland Clinic Foundation, Cleveland, OH; Memorial Sloan-Kettering Cancer Center, New York, NY; Mayo Clinic College of Medicine, Rochester, MN; Baylor College of Medicine; The University of Texas M.D. Anderson Cancer Center, Houston; The University of Texas Southwestern Medical Center, Dallas, TX; Duke University School of Medicine, Durham, NC; Washington University School of Medicine, St Louis, MO; University of Michigan Medical Center, Ann Arbor, MI; University of Washington School of
Theodore L DeWeese - From the Cleveland Clinic Foundation, Cleveland, OH; Memorial Sloan-Kettering Cancer Center, New York, NY; Mayo Clinic College of Medicine, Rochester, MN; Baylor College of Medicine; The University of Texas M.D. Anderson Cancer Center, Houston; The University of Texas Southwestern Medical Center, Dallas, TX; Duke University School of Medicine, Durham, NC; Washington University School of Medicine, St Louis, MO; University of Michigan Medical Center, Ann Arbor, MI; University of Washington School of
Stanley L Liauw - From the Cleveland Clinic Foundation, Cleveland, OH; Memorial Sloan-Kettering Cancer Center, New York, NY; Mayo Clinic College of Medicine, Rochester, MN; Baylor College of Medicine; The University of Texas M.D. Anderson Cancer Center, Houston; The University of Texas Southwestern Medical Center, Dallas, TX; Duke University School of Medicine, Durham, NC; Washington University School of Medicine, St Louis, MO; University of Michigan Medical Center, Ann Arbor, MI; University of Washington School of
Richard K Valicenti - From the Cleveland Clinic Foundation, Cleveland, OH; Memorial Sloan-Kettering Cancer Center, New York, NY; Mayo Clinic College of Medicine, Rochester, MN; Baylor College of Medicine; The University of Texas M.D. Anderson Cancer Center, Houston; The University of Texas Southwestern Medical Center, Dallas, TX; Duke University School of Medicine, Durham, NC; Washington University School of Medicine, St Louis, MO; University of Michigan Medical Center, Ann Arbor, MI; University of Washington School of
Deborah A Kuban - From the Cleveland Clinic Foundation, Cleveland, OH; Memorial Sloan-Kettering Cancer Center, New York, NY; Mayo Clinic College of Medicine, Rochester, MN; Baylor College of Medicine; The University of Texas M.D. Anderson Cancer Center, Houston; The University of Texas Southwestern Medical Center, Dallas, TX; Duke University School of Medicine, Durham, NC; Washington University School of Medicine, St Louis, MO; University of Michigan Medical Center, Ann Arbor, MI; University of Washington School of
Alan Pollack - From the Cleveland Clinic Foundation, Cleveland, OH; Memorial Sloan-Kettering Cancer Center, New York, NY; Mayo Clinic College of Medicine, Rochester, MN; Baylor College of Medicine; The University of Texas M.D. Anderson Cancer Center, Houston; The University of Texas Southwestern Medical Center, Dallas, TX; Duke University School of Medicine, Durham, NC; Washington University School of Medicine, St Louis, MO; University of Michigan Medical Center, Ann Arbor, MI; University of Washington School of
Publication Details: Journal of clinical oncology, Vol.25(15), pp.2035-2041
Academic Unit: Leadership Department; Miller School of Medicine; UMMG Dept of Radiation Oncology
Language: English
Resource Type: Journal article
PMID: 17513807
PMCID: PMC2670394
Record Identifier: 991031559578802976