Scientists to report on the risk of extraprostatic spread in PCa patients and its implications for adjuvant therapy

Monday, 25 May 2009- Results of a population-based analysis of 23,988 patients, conducted as part of a multi-centre study on the pathologic rates of EPE or positive margins in clinically localised prostate cancer, will be reported in the upcoming 2009 ASCO Annual Meeting to take place on 29 May - 2 June 2009 in Orlando, US.

The study followed up on recent reports including that by Swanson et al., which presented an update of SWOG 8794 revealing a 10% absolute overall survival benefit at 15 years with adjuvant radiation therapy for patients with extraprostatic extension (EPE) or positive margins after radical prostatectomy (RP).

In their population based analysis, the authors analyse and report on the pathologic rates of EPE or positive margins in clinically localised prostate cancer as well as how often these patients have received adjuvant radiation therapy.

The Surveillance, Epidemiology and End Results (SEER) registry was used to identify patients between 2004-2005 with clinically staged T1-T2c prostate cancer who underwent radical prostatectomy. Patients were stratified using NCCN risk groups into low (T1c- T2a, PSA less than 10ng/ml, Gleason 2-6), intermediate (T2b, PSA 10-20ng/ml, Gleason 7), and high (T2c, PSA greater than 20ng/ml, Gleason 8-10).

23,988 patients were identified: 6,314 in the NCCN low risk group (LR), 12,052 in the NCCN intermediate risk group (IR), and 5,622 in the NCCN high risk group (HR). Overall, 68.2% of patients had organ-confined disease with negative margins.

However, the risk of EPE or positive margins increased with the NCCN risk group, PSA value, and Gleason score. Of those who met criteria for adjuvant radiation, 11.9% received the treatment: 4.7% of the LR group, 9.2% of the IR group and 18.9% of the HR group.

The authors conclude that patients can use this data to be counselled on their risk of requiring adjuvant radiation based on their pre-treatment parameters. This data also reveals that nearly one third of all patients met the indications for adjuvant radiation, but only a small percentage of them received this treatment.

Source: D. Schreiber, J. Rineer et al. “Radical prostatectomy in clinically localized prostate cancer - The risk of extraprostatic spread by NCCN risk group and its implications for adjuvant therapy: An analysis of 23,988 patients.” Abstract No: 5125, J Clin Oncol 27:15s, 2009

 


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