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P085 Salvage pelvic lymph node dissection in prostate cancer: Surgical and oncological outcome
140
A B S T R A C T S / E U R O P E A N U R O L O G Y S U P P L E M E N T S 13 (2014) 103—194
Material & Methods: The design was an observational, retrospective study of efficacy/safety carried out by 30 office-based urologists in Germany in 647 patients. Data were collected retrospectively for the time period from 1992 to 2012. Results: In the treatment group response rate according to EORTC criteria was 94.4% after 6 months of LHRHa treatment and remained above 90% for 10 years of treatment. PSA levels fell from 8.09 ng/ml (median, IR [3.02–19.00]) to 0.40 ng/ml (IR [0.10–1.31]) after 6 months. PSA levels are >90% declined compared to baseline at all time-points. Testosterone levels were at baseline 3.97 ng/ml (median, IR [2.02–4.80]), dropped to castration level (<0.5 ng/mL) within 6 months and were suppressed ≤0.20 ng/mL (median) at all time points until 13 years of LHRHa treatment. Conclusions: More than 90% of the observed patients showed response (EORTC criteria) for >10 years of treatment. Median testosterone level was suppressed considerably below castration level, PSA declined subsequently and remained low for all time points of observation up to 13 years. Thus, leuprorelin acetate in microcapsules is an effective long term treatment for patients with advanced prostate cancer. P083 Analysis of geometric shifts for determination of proper margin in prostate cancer patients treated with SIB-IMRT using endorectal ballooning and daily enema for prostate immobilization S. Jeong, J.H. Lee, M.J. Chung, S.W. Lee, D.G. Kang, S.H. Kim. St. Vincent Hospital, The Catholic Univ. of Korea, College of Medicine, Dept. of Radiation Oncology, Suwon, South Korea Introduction & Objectives: The aim of this study was to evaluate geometric shifts of daily patient setup and determine the effective target margins in prostate cancer patients in treating radiotherapy, especially when applying intensity modulated-simultaneous boost technique. Material & Methods: From 2011 to 2013, total 1050 set of pretreatment MVCT scans, acquired from 35 prostate cancer patients who were treated with Helical Tomotherapy were reviewed. Patients who treated prostate only were excluded and all patients evaluated were treated both pelvic lymphatics and prostate/prostate op bed using SIB technique. Daily geometric shifts data of patient setup in Right-to-left (X), Anterior-to-posterior (Y), Superior-to-inferior (Z), and Angle of collimator (roll) were collected and fraction-to-fraction Systemic error () and Random error (δ) were evaluated. The recommended planning target margin to cover setup variation is calculated using the equation: margin = 2 + 0.7δ. Daily endorectal balloon insertion and pre-treatment enema were performed to minimize prostate mobility in conjunction with bladder emptying. Because radiotherapy was intended to deliver prostate or prostatectomy bed simultaneously with pelvic lymphatics, initial auto-registration of daily MVCT to initial planning CT was performed in bone-matched session and followed by manual registration to adjust internal organ movement. Results: The radiotherapy was delivered to prostate with radical aim upto 70.5 Gy in 30 fx and to prostatectomy bed with adjuvant or salvage aim upto 63 Gy in 30 fx. 48 Gy of radiation dose delived to pelvic lymphatics. All patients were diagnosed cT2/3 and intermediate to high risk group prostate cancer. The mean geometric shifts in Rightto-left (X), Anterior-to-posterior (Y), Superior-to-inferior (Z), and Angle of collimator (roll) were 4.61mm, 3.10mm, 2.60mm and 1.33° in all patients. Evaluated mean Systemic error () and Random error (δ) of all patients were 1.93mm (x), 1.57mm (y), 1.83mm (z), 0.68° (roll) and 2.12mm (x), 1.62mm (y), 1.42mm (z), 0.58° (roll). The calculated recommended planning target margins were 5.35 (x), 4.28 (y), 4.66 (z). There were no severe acute and late normal organ toxicity over grade 3, like rectal bleeding during and after treatment follow up. Conclusions: The patients who need to deliver radiation to pelvic
lymphatics as well as prostate or prostate bed, should consider relative position, movement and distance of prostate or rectum with entire pelvis setup. When limitation of interfraction intrapelvic organ, using daily MVCT geometric shifts data can be convenient and effective way to evaluate and determine proper target margin. P084 Delayed hormonal therapy could be an option in selected patients with lymph node metastases after surgical treatment K.M. Nyushko 1 , B.Y. Alekseev 1 , A.A. Krasheninnikov 1 , A.S. Kalpinskiy 1 , N.V. Vorobyev 1 , M.P. Golovaschenko 1 , L.V. Moskvina 2 , A.D. Kaprin 3 . 1 P.A. Herzen Moscow Oncological Research Institute, Dept. of Urology, Moscow, Russia; 2 P.A. Herzen Moscow Oncological Research Institute, Dept. of Pathology, Moscow, Russia; 3 P.A. Herzen Moscow Oncological Research Institute, Head of Institution, Moscow, Russia Introduction & Objectives: Lymph node invasion (LNI) is a poor prognostic factor in prostate cancer (PC) patients (pts) undergone radical prostatectomy (RPE) and pelvic lymph node dissection (PLND) and often require immediate adjuvant hormonal therapy (ADT). The question if ADT could be delayed is controversial. The aim of the study was to assess biochemical progression-free survival (BPFS) in different prognostic subgroups of LN positive PC pts. Material & Methods: Retrospective analysis of 1430 PC pts undergone RPE and PLND since 1998 till 2014 was done. LN metastases were verified in 229 (16%). Mean PSA level was 23.8±23.3 ng/ml; mean percentage of positive biopsy cores (PPBC) was 76.4±27.7%. Clinical stage was T1b-T2c in 111 (48.5%), T3a-T3b – in 118 (51.5%). Biopsy Gleason score ≤6 was verified in 57 (24.9%) pts; 7 (3+4) – in 58 (25.3%); 7 (4+3) – in 68 (29.7%) and 8–10 – in 37 (16.2%); not assessed in 9 (3.9%) pts. Low risk PC was verified in 5 (2.2%) pts, intermediate risk – in 44 (19.2%) pts and high risk – in 180 (78.6%) pts. Biochemical recurrence (BR) was assessed as elevation of PSA>0.2 ng/ml on three consecutive measurements. Pts with immediate ADT after the operation were excluded. Results: Mean number of LN removed was 23±9 (2–53). Mean follow up time was 29.6±24.9 months (3–125 months). BR was observed in 91 (39.7%) pts. 3-year biochemical progression-free survival (BPFS) was 21.1±4.6%. 3-year BPFS in subgroup of pts undergone extended vs. standard PLND was 27.9±6.8% and 15.3±5.6%, respectively (p=0.02); in pts with ≤2 positive LN vs. >2 positive LN it was 33.1±6.9% and 6.8±4.3%, respectively (p=0.0002); in pts with positive LN density <15% vs. ≥15% was 30.3±6.4% and 7.3±4.7% (p=0.001) and in pts with presence of metastatic LN extra capsular extension (LN ECE) vs. absence of LN ECE it was 9.2±5.2% and 31.8±8.2%, respectively (p=0.003). In pts with LN metastases only in 1 anatomical region vs. in ≥2 regions 3-year BPFS was 33.2±7.1% and 9.4±4.8%, respectively (p=0.008). Conclusions: In LN positive pts underwent RPE and extended PLND with ≤2 positive LN, LN density <15%, absence of LN ECE and only 1 anatomical region involved delayed ADT could be an option. P085 Salvage pelvic lymph node dissection in prostate cancer: Surgical and oncological outcome T. Claeys 1 , C. Van Praet 1 , K. Decaestecker 1 , P. Ost 2 , V. Fonteyne 2 , G. De Meerleer 2 , P. De Visschere 3 , G. Villeirs 3 , N. Lumen 1 . 1 Universitair Ziekenhuis Gent, Dept. of Urology, Ghent, Belgium; 2 Universitair Ziekenhuis Gent, Dept. of Radiation Oncology, Ghent, Belgium; 3 Universitair Ziekenhuis Gent, Dept. of Radiology, Ghent, Belgium Introduction & Objectives: To evaluate morbidity and oncological outcome of salvage pelvic lymph node dissection (PLND) in patients with prostate-specific antigen (PSA) rise after local curative treatment for prostate cancer.
A B S T R A C T S / E U R O P E A N U R O L O G Y S U P P L E M E N T S 13 (2014) 103—194
Material & Methods: We retrospectively analyzed records of 17 patients undergoing salvage PLND from 2009 to 2014. Indications for PLND were treatment of oligometastatic disease (0.2ng/ml. Nonresponders did not show a drop in PSA. Biochemical recurrence after cBR was defined as an increase in PSA >0.2 ng/ml on 2 consecutive measurements. After iBR 2 consecutive PSA rises were considered as biochemical progression. A new metastatic site on postoperative imaging was defined as clinical progression (CP). Palliative androgen deprivation therapy (ADT) was initiated if >3 metastases were detected or if patients became symptomatic. Kaplan-Meier statistics were applied to determine PSA progression-, CP- and ADT-free survival (FS). Results: Two laparoscopic interventions were converted to open surgery because of extensive adhesions. Grade 1, 2, 3a and 3b complications were seen in 6 (33.3%), 1 (5.5%), 1 (5.5%) and 2 (11%) patients respectively. Median follow-up time was 21 months (range 1– 60). Among 13 patients treated for oligometastatic disease, all with histopathological LN involvement, 8 (62%) had a postoperative PSA decline including 2 patients (15%) that showed cBR. Median PSA progression-FS was 2.8 months. Seven patients (54%) showed CP: 1 solely to pelvic LNs outside PLND template, 1 to pelvic LNs within PLND template and to the bone, 3 to retroperitoneal LNs, 1 to the bone and 1 to the spongious body. Median CP-FS was 12 months. Four (31%) and 1 (8%) patients were treated with 1 and 2 additional oligometastasis-directed therapies respectively. Three patients (23%) started palliative ADT, resulting in a 2 year ADT-FS rate of 60%.
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disease characteristics were predictive for the median duration of the first cycle off-treatment period. Materials & Methods: 191 men with prostate cancer (all stages) with a baseline prostate specific antigen (PSA) >4 ng/mL or a PSA doubling time 4 ng/mL were estimated using the Weibull model with 3 disease classifiers: PSA at baseline, prostate cancer stage and Gleason score. Results: The model with all 3 disease factors showed that Gleason score (4 ng/mL (p=0.934). The estimated median times using a reduced model with PSA and prostate cancer stage at baseline are shown in the figure. Baseline PSA was highly predictive (p<0.0001) of the time to PSA >4 ng/mL with the lowest PSA group (≤4 ng/mL) having the longest off-treatment period. The relative delay in failure time (time to PSA >4ng/mL) for the baseline PSA ≤4 versus PSA >20 ng/mL subgroups was 3.96 (95% confidence interval [CI]: 2.69; 5.83), p 4 ng/mL (95% CI) of 948.3 (717; 1255) days compared to 239.3 (184; 312) days for the same group of patients with a baseline PSA >20 ng/mL. Prostate cancer stage/previous therapy also influenced (P=0.0555) the time to PSA >4 ng/mL with longer times for patients previously treated with curative intent or with localised disease compared to those with locally advanced or metastatic prostate cancer.
Figure 1
Conclusions: Patients with lower PSA (≤4 ng/mL) levels at baseline, or patients with less extensive disease have longer median offtreatment periods after receiving IAD therapy with degarelix. Median time (days) to PSA >4 ng/mL using baseline PSA and prostate cancer stages as factors.
Figure 1. PSA changes within 40 days post-surgery.
Conclusions: Salvage PLND is feasible, both open and minimally invasive, but postoperative complication rate is rather high as compared to primary PLND series. Although only a limited number of patients has a durable response, as part of an oligometastic treatment regime it can defer palliative ADT. P086 Disease characteristics influencing the duration of the off-treatment period during intermittent androgen deprivation therapy with degarelix in prostate cancer P-A. Abrahamsson 1 , P. Albers 2 , J. Morote Robles 3 , A. Malmberg 4 , A.N. Neijber 5 , L. Boccon-Gibod 6 . 1 Skåne University Hospital, Dept. of Urology, Malmö, Sweden; 2 Heinrich-Heine Universitätsklinikum, Dept. of Urology, Düsseldorf, Germany; 3 Vall d’Hebron University Hospital, Dept. of Urology, Barcelona, Spain; 4 Ferring Pharmaceuticals A/S, Dept. of Global Biometrics, Malmö, Sweden; 5 Ferring Pharmaceuticals A/S, Dept. of Urology, Copenhagen, Denmark; 6 Hôpital Bichat – Claude Bernard, Dept. of Urology, Paris, France Introduction & Objectives: Intermittent (IAD) therapy is commonly used in prostate cancer. The objective of this analysis of trial data of IAD therapy with degarelix in prostate cancer was to establish how
P087 Body mass index as predictive and prognostic factor for chemotherapy for metastatic prostate cancer patients E. Nowara, J. Huszno. Centrum Onkologii Instytut Gliwice Branch, Dept. of Oncology and Experimental Chemotherapy, Gliwice, Poland Introduction & Objectives: Polish society has become more and more overweigh during last decades. Cancer patients are increasingly overweight or obese. The aim of this study was to estimate whether Body Mass Index (BMI) affects the docetaxel chemotherapy response and survival for metastatic prostate cancer (MPC) patients (pts). Material & Methods: This retrospective study was conducted in Clinical and Experimental Oncology Department, MSC Memorial Cancer Center and Institute of Oncology in Gliwice Poland (COI). All pts were diagnosed, treated and followed up in COI. Patients’ medical records were reviewed according to national law regulation. The analysis included 81 consecutive MPC patients treated with docetaxel during 2008–2013. The median age at diagnosis was 63 years (range 41–81). 38% of pts had history of alcohol abuse or smoking. 44% had comorbid conditions, the most frequent was hypertension and diabetes, 36 and 14% respectively. 17% of pts had BMI in normal range (<25), 50% were overweight (25.1–29.9) and 33% were obese (>30). 21% of pts had radical prostatectomy and 43% had radical radiotherapy. The remaining pts had palliative treatment due to primary dissemination. All of pts had hormonotherapy. The median hormonotherapy time
A B S T R A C T S / E U R O P E A N U R O L O G Y S U P P L E M E N T S 13 (2014) 103—194
Material & Methods: The design was an observational, retrospective study of efficacy/safety carried out by 30 office-based urologists in Germany in 647 patients. Data were collected retrospectively for the time period from 1992 to 2012. Results: In the treatment group response rate according to EORTC criteria was 94.4% after 6 months of LHRHa treatment and remained above 90% for 10 years of treatment. PSA levels fell from 8.09 ng/ml (median, IR [3.02–19.00]) to 0.40 ng/ml (IR [0.10–1.31]) after 6 months. PSA levels are >90% declined compared to baseline at all time-points. Testosterone levels were at baseline 3.97 ng/ml (median, IR [2.02–4.80]), dropped to castration level (<0.5 ng/mL) within 6 months and were suppressed ≤0.20 ng/mL (median) at all time points until 13 years of LHRHa treatment. Conclusions: More than 90% of the observed patients showed response (EORTC criteria) for >10 years of treatment. Median testosterone level was suppressed considerably below castration level, PSA declined subsequently and remained low for all time points of observation up to 13 years. Thus, leuprorelin acetate in microcapsules is an effective long term treatment for patients with advanced prostate cancer. P083 Analysis of geometric shifts for determination of proper margin in prostate cancer patients treated with SIB-IMRT using endorectal ballooning and daily enema for prostate immobilization S. Jeong, J.H. Lee, M.J. Chung, S.W. Lee, D.G. Kang, S.H. Kim. St. Vincent Hospital, The Catholic Univ. of Korea, College of Medicine, Dept. of Radiation Oncology, Suwon, South Korea Introduction & Objectives: The aim of this study was to evaluate geometric shifts of daily patient setup and determine the effective target margins in prostate cancer patients in treating radiotherapy, especially when applying intensity modulated-simultaneous boost technique. Material & Methods: From 2011 to 2013, total 1050 set of pretreatment MVCT scans, acquired from 35 prostate cancer patients who were treated with Helical Tomotherapy were reviewed. Patients who treated prostate only were excluded and all patients evaluated were treated both pelvic lymphatics and prostate/prostate op bed using SIB technique. Daily geometric shifts data of patient setup in Right-to-left (X), Anterior-to-posterior (Y), Superior-to-inferior (Z), and Angle of collimator (roll) were collected and fraction-to-fraction Systemic error () and Random error (δ) were evaluated. The recommended planning target margin to cover setup variation is calculated using the equation: margin = 2 + 0.7δ. Daily endorectal balloon insertion and pre-treatment enema were performed to minimize prostate mobility in conjunction with bladder emptying. Because radiotherapy was intended to deliver prostate or prostatectomy bed simultaneously with pelvic lymphatics, initial auto-registration of daily MVCT to initial planning CT was performed in bone-matched session and followed by manual registration to adjust internal organ movement. Results: The radiotherapy was delivered to prostate with radical aim upto 70.5 Gy in 30 fx and to prostatectomy bed with adjuvant or salvage aim upto 63 Gy in 30 fx. 48 Gy of radiation dose delived to pelvic lymphatics. All patients were diagnosed cT2/3 and intermediate to high risk group prostate cancer. The mean geometric shifts in Rightto-left (X), Anterior-to-posterior (Y), Superior-to-inferior (Z), and Angle of collimator (roll) were 4.61mm, 3.10mm, 2.60mm and 1.33° in all patients. Evaluated mean Systemic error () and Random error (δ) of all patients were 1.93mm (x), 1.57mm (y), 1.83mm (z), 0.68° (roll) and 2.12mm (x), 1.62mm (y), 1.42mm (z), 0.58° (roll). The calculated recommended planning target margins were 5.35 (x), 4.28 (y), 4.66 (z). There were no severe acute and late normal organ toxicity over grade 3, like rectal bleeding during and after treatment follow up. Conclusions: The patients who need to deliver radiation to pelvic
lymphatics as well as prostate or prostate bed, should consider relative position, movement and distance of prostate or rectum with entire pelvis setup. When limitation of interfraction intrapelvic organ, using daily MVCT geometric shifts data can be convenient and effective way to evaluate and determine proper target margin. P084 Delayed hormonal therapy could be an option in selected patients with lymph node metastases after surgical treatment K.M. Nyushko 1 , B.Y. Alekseev 1 , A.A. Krasheninnikov 1 , A.S. Kalpinskiy 1 , N.V. Vorobyev 1 , M.P. Golovaschenko 1 , L.V. Moskvina 2 , A.D. Kaprin 3 . 1 P.A. Herzen Moscow Oncological Research Institute, Dept. of Urology, Moscow, Russia; 2 P.A. Herzen Moscow Oncological Research Institute, Dept. of Pathology, Moscow, Russia; 3 P.A. Herzen Moscow Oncological Research Institute, Head of Institution, Moscow, Russia Introduction & Objectives: Lymph node invasion (LNI) is a poor prognostic factor in prostate cancer (PC) patients (pts) undergone radical prostatectomy (RPE) and pelvic lymph node dissection (PLND) and often require immediate adjuvant hormonal therapy (ADT). The question if ADT could be delayed is controversial. The aim of the study was to assess biochemical progression-free survival (BPFS) in different prognostic subgroups of LN positive PC pts. Material & Methods: Retrospective analysis of 1430 PC pts undergone RPE and PLND since 1998 till 2014 was done. LN metastases were verified in 229 (16%). Mean PSA level was 23.8±23.3 ng/ml; mean percentage of positive biopsy cores (PPBC) was 76.4±27.7%. Clinical stage was T1b-T2c in 111 (48.5%), T3a-T3b – in 118 (51.5%). Biopsy Gleason score ≤6 was verified in 57 (24.9%) pts; 7 (3+4) – in 58 (25.3%); 7 (4+3) – in 68 (29.7%) and 8–10 – in 37 (16.2%); not assessed in 9 (3.9%) pts. Low risk PC was verified in 5 (2.2%) pts, intermediate risk – in 44 (19.2%) pts and high risk – in 180 (78.6%) pts. Biochemical recurrence (BR) was assessed as elevation of PSA>0.2 ng/ml on three consecutive measurements. Pts with immediate ADT after the operation were excluded. Results: Mean number of LN removed was 23±9 (2–53). Mean follow up time was 29.6±24.9 months (3–125 months). BR was observed in 91 (39.7%) pts. 3-year biochemical progression-free survival (BPFS) was 21.1±4.6%. 3-year BPFS in subgroup of pts undergone extended vs. standard PLND was 27.9±6.8% and 15.3±5.6%, respectively (p=0.02); in pts with ≤2 positive LN vs. >2 positive LN it was 33.1±6.9% and 6.8±4.3%, respectively (p=0.0002); in pts with positive LN density <15% vs. ≥15% was 30.3±6.4% and 7.3±4.7% (p=0.001) and in pts with presence of metastatic LN extra capsular extension (LN ECE) vs. absence of LN ECE it was 9.2±5.2% and 31.8±8.2%, respectively (p=0.003). In pts with LN metastases only in 1 anatomical region vs. in ≥2 regions 3-year BPFS was 33.2±7.1% and 9.4±4.8%, respectively (p=0.008). Conclusions: In LN positive pts underwent RPE and extended PLND with ≤2 positive LN, LN density <15%, absence of LN ECE and only 1 anatomical region involved delayed ADT could be an option. P085 Salvage pelvic lymph node dissection in prostate cancer: Surgical and oncological outcome T. Claeys 1 , C. Van Praet 1 , K. Decaestecker 1 , P. Ost 2 , V. Fonteyne 2 , G. De Meerleer 2 , P. De Visschere 3 , G. Villeirs 3 , N. Lumen 1 . 1 Universitair Ziekenhuis Gent, Dept. of Urology, Ghent, Belgium; 2 Universitair Ziekenhuis Gent, Dept. of Radiation Oncology, Ghent, Belgium; 3 Universitair Ziekenhuis Gent, Dept. of Radiology, Ghent, Belgium Introduction & Objectives: To evaluate morbidity and oncological outcome of salvage pelvic lymph node dissection (PLND) in patients with prostate-specific antigen (PSA) rise after local curative treatment for prostate cancer.
A B S T R A C T S / E U R O P E A N U R O L O G Y S U P P L E M E N T S 13 (2014) 103—194
Material & Methods: We retrospectively analyzed records of 17 patients undergoing salvage PLND from 2009 to 2014. Indications for PLND were treatment of oligometastatic disease (0.2ng/ml. Nonresponders did not show a drop in PSA. Biochemical recurrence after cBR was defined as an increase in PSA >0.2 ng/ml on 2 consecutive measurements. After iBR 2 consecutive PSA rises were considered as biochemical progression. A new metastatic site on postoperative imaging was defined as clinical progression (CP). Palliative androgen deprivation therapy (ADT) was initiated if >3 metastases were detected or if patients became symptomatic. Kaplan-Meier statistics were applied to determine PSA progression-, CP- and ADT-free survival (FS). Results: Two laparoscopic interventions were converted to open surgery because of extensive adhesions. Grade 1, 2, 3a and 3b complications were seen in 6 (33.3%), 1 (5.5%), 1 (5.5%) and 2 (11%) patients respectively. Median follow-up time was 21 months (range 1– 60). Among 13 patients treated for oligometastatic disease, all with histopathological LN involvement, 8 (62%) had a postoperative PSA decline including 2 patients (15%) that showed cBR. Median PSA progression-FS was 2.8 months. Seven patients (54%) showed CP: 1 solely to pelvic LNs outside PLND template, 1 to pelvic LNs within PLND template and to the bone, 3 to retroperitoneal LNs, 1 to the bone and 1 to the spongious body. Median CP-FS was 12 months. Four (31%) and 1 (8%) patients were treated with 1 and 2 additional oligometastasis-directed therapies respectively. Three patients (23%) started palliative ADT, resulting in a 2 year ADT-FS rate of 60%.
141
disease characteristics were predictive for the median duration of the first cycle off-treatment period. Materials & Methods: 191 men with prostate cancer (all stages) with a baseline prostate specific antigen (PSA) >4 ng/mL or a PSA doubling time 4 ng/mL were estimated using the Weibull model with 3 disease classifiers: PSA at baseline, prostate cancer stage and Gleason score. Results: The model with all 3 disease factors showed that Gleason score (4 ng/mL (p=0.934). The estimated median times using a reduced model with PSA and prostate cancer stage at baseline are shown in the figure. Baseline PSA was highly predictive (p<0.0001) of the time to PSA >4 ng/mL with the lowest PSA group (≤4 ng/mL) having the longest off-treatment period. The relative delay in failure time (time to PSA >4ng/mL) for the baseline PSA ≤4 versus PSA >20 ng/mL subgroups was 3.96 (95% confidence interval [CI]: 2.69; 5.83), p 4 ng/mL (95% CI) of 948.3 (717; 1255) days compared to 239.3 (184; 312) days for the same group of patients with a baseline PSA >20 ng/mL. Prostate cancer stage/previous therapy also influenced (P=0.0555) the time to PSA >4 ng/mL with longer times for patients previously treated with curative intent or with localised disease compared to those with locally advanced or metastatic prostate cancer.
Figure 1
Conclusions: Patients with lower PSA (≤4 ng/mL) levels at baseline, or patients with less extensive disease have longer median offtreatment periods after receiving IAD therapy with degarelix. Median time (days) to PSA >4 ng/mL using baseline PSA and prostate cancer stages as factors.
Figure 1. PSA changes within 40 days post-surgery.
Conclusions: Salvage PLND is feasible, both open and minimally invasive, but postoperative complication rate is rather high as compared to primary PLND series. Although only a limited number of patients has a durable response, as part of an oligometastic treatment regime it can defer palliative ADT. P086 Disease characteristics influencing the duration of the off-treatment period during intermittent androgen deprivation therapy with degarelix in prostate cancer P-A. Abrahamsson 1 , P. Albers 2 , J. Morote Robles 3 , A. Malmberg 4 , A.N. Neijber 5 , L. Boccon-Gibod 6 . 1 Skåne University Hospital, Dept. of Urology, Malmö, Sweden; 2 Heinrich-Heine Universitätsklinikum, Dept. of Urology, Düsseldorf, Germany; 3 Vall d’Hebron University Hospital, Dept. of Urology, Barcelona, Spain; 4 Ferring Pharmaceuticals A/S, Dept. of Global Biometrics, Malmö, Sweden; 5 Ferring Pharmaceuticals A/S, Dept. of Urology, Copenhagen, Denmark; 6 Hôpital Bichat – Claude Bernard, Dept. of Urology, Paris, France Introduction & Objectives: Intermittent (IAD) therapy is commonly used in prostate cancer. The objective of this analysis of trial data of IAD therapy with degarelix in prostate cancer was to establish how
P087 Body mass index as predictive and prognostic factor for chemotherapy for metastatic prostate cancer patients E. Nowara, J. Huszno. Centrum Onkologii Instytut Gliwice Branch, Dept. of Oncology and Experimental Chemotherapy, Gliwice, Poland Introduction & Objectives: Polish society has become more and more overweigh during last decades. Cancer patients are increasingly overweight or obese. The aim of this study was to estimate whether Body Mass Index (BMI) affects the docetaxel chemotherapy response and survival for metastatic prostate cancer (MPC) patients (pts). Material & Methods: This retrospective study was conducted in Clinical and Experimental Oncology Department, MSC Memorial Cancer Center and Institute of Oncology in Gliwice Poland (COI). All pts were diagnosed, treated and followed up in COI. Patients’ medical records were reviewed according to national law regulation. The analysis included 81 consecutive MPC patients treated with docetaxel during 2008–2013. The median age at diagnosis was 63 years (range 41–81). 38% of pts had history of alcohol abuse or smoking. 44% had comorbid conditions, the most frequent was hypertension and diabetes, 36 and 14% respectively. 17% of pts had BMI in normal range (<25), 50% were overweight (25.1–29.9) and 33% were obese (>30). 21% of pts had radical prostatectomy and 43% had radical radiotherapy. The remaining pts had palliative treatment due to primary dissemination. All of pts had hormonotherapy. The median hormonotherapy time