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The prognostic significance of local recurrence in prostate carcinoma after definitive radiotherapy
Proceedings of the 33rd Annual ASTRO Meeting
153
conclnsim:
Overall and disease-specific survival was similar among positive and negative hlopsy from the time of initial diagnosis. flowever, a less favorable course may be predicted from the posittve post-irradiation prostatic biopsy, even in the absence of disease elsewhere, dlue to the risk of slc&zquent distant metastases. Since patients with positive post-treatment hlopsies inittally present with more locally advanced disease, these data suggest a subset of patients benefit from more aggressive initial local therapy.
pattents time of a Increased tended to that may
73 THE PROGNOSTICSIGNIFICANCEOF LOCAL RECURRENCE IN PROSTATECARCINOMAAFTER DEFINITIVE RADIOTHERAPY PP Lai,
CA Perez,
Radiation
Oncology
MA Lock.ett Center,
Mallinckrodt
Institute
of Radiology,
Washington
University,
St.
Louis,
MO
Purpose: To analyze the prognostic significance of local recurrence in prostate carcinoma patients, without synchronous distant metastasis after definitive radiotherapy and to identify factors that affect survival of such patients. Materials & Methods: This is a retrospective analysis of 713 biopsy confirmed, clinical stage A2 C prostate carcinoma patients who received definitive radiotherapy at the Hallinckrodt Institute of Radiology between 1967 and 1988. Of these patients 298 (42%) were found to have a recurrence; 70 (10%) experienced a local recurrence as the first site of recurrence without synchronous distant metastasis; 93 (13%) experienced synchronous local recurrence and distant metastasis, while 135 (19%) reported distant metastasis as the first site of recurrence. The diagnosis of local recurrence was by biopsy in 27 patients while the others were based on clinical evidence. Salvage treatment is as follows: 12 TUR, 1 implant, 3 chemotherapy, 23 orchiectomy, 20 hormones, 2 external radiotherapy and 9 others. Results: The median survival, from time of recurrence, for all patients was 2.75 years, with a 5, 8, and 10 years probability of survival of 25X, 12X, and 7.5X, respectively. For those who experienced a local recurrence as the first site of recurrence without synchronous distant metastasis the 5, 8, 10 year probability of survival was 48X, 27X, and 18X, respectively. The time of recurrence after initial radiotherapy affects significantly subsequent survival; the 5-year actuarial survival from the time of who recurred within 2 years, 3-5 years, recurrence, for local recurrence was 21X, 47% and 94X, for those and more than 5 years, respectively. The time of recurrence did not affect subsequent patient survival when distant metastasis is involved. Initial stage influenced survival after patient experienced a local recurrence; the [j-year survival for patients who experienced a local recurrence with initial stage B disease was 71% as opposed to 36% for patients with an initial stage C disease. Initial histological grade did not affect patient survival who experienced a local recurrence; 5-year survival from time of recurrence was 49X, 46X, and 47% for those with initial well, moderately, and poorly differentiated histology. Patients with a local recurrence without synchronous distant metastasis after Conclusion: definitive radiotherapy is associated with a favorable prognosis compared to those with distant The factors that effect subsequent patient survival after they experienced a local metastasis. recurrence include initial stage and time of recurrence, while initial histologic grade has no influence on subsequent patient survival after local recurrence.
74 THE PROGNOSTIC SIGNIFICANCE? OF RACE AND SURVIVAL PROM PROSTATE CANCER BASED ON RTOG RANDOMIZED TRIALS 7506, 7706, AND 8307 Mack Roach III, M.D.l, Minhce Won, M.A.2, James W.Kel1e.r. M.D.3, William T. Sause, M.D.5, R.L. Scotte Doggett, M.D.6, Marvin Rotman, Miljenko V.Pilepich, M.D.9, Sucha 0. Asbell, M.D. lo
Carlos A.Perez, M.D.4 , M.D.7, Russ Homer, M.D.8,
‘Department of Radiaton Oncolo~,y, University of California, San Francisco CA ; *The Radiaton Therapy Oncology ; 3University of Rochester. Rochester NY : 4Washington University. St.Louis, MO
Headquarters. Philedelphia, PA Hospital, Salt Lake City, UT
9C.MCAuley
; 6R:ldiation
Oncology Center Sacramento CA, 7SUNY/F3rooklyn. NY
Health Center Ann Arbor. MI ;l” Albert Einstein.
Phildelphia,
;
Group
;
5LDS
8Marshfield Clinic, WIS.
:
PA
To evaluate the prognostic significance of race and survival from prostate cancer using data from DrosDective randomized RTOCi trials 7506, 7706 and 8307 and MethPds; From 1976 to 1985, >1200 patients were entered on three RTOG prospective randomized trials for prostate cancer. Approximately 10% of the patients entered on these trials were coded as Black while nearly all of the Protocol 7706 included 484 patients with clinical stage A2 or B who remaining patients were coded as White. Only patients without were randomized to receive prostate irradiation only or pelvic plus prostate irradiation. Protocol 7506 included 607 patients with stage C or evidence of node involvement were included in this study.
153
conclnsim:
Overall and disease-specific survival was similar among positive and negative hlopsy from the time of initial diagnosis. flowever, a less favorable course may be predicted from the posittve post-irradiation prostatic biopsy, even in the absence of disease elsewhere, dlue to the risk of slc&zquent distant metastases. Since patients with positive post-treatment hlopsies inittally present with more locally advanced disease, these data suggest a subset of patients benefit from more aggressive initial local therapy.
pattents time of a Increased tended to that may
73 THE PROGNOSTICSIGNIFICANCEOF LOCAL RECURRENCE IN PROSTATECARCINOMAAFTER DEFINITIVE RADIOTHERAPY PP Lai,
CA Perez,
Radiation
Oncology
MA Lock.ett Center,
Mallinckrodt
Institute
of Radiology,
Washington
University,
St.
Louis,
MO
Purpose: To analyze the prognostic significance of local recurrence in prostate carcinoma patients, without synchronous distant metastasis after definitive radiotherapy and to identify factors that affect survival of such patients. Materials & Methods: This is a retrospective analysis of 713 biopsy confirmed, clinical stage A2 C prostate carcinoma patients who received definitive radiotherapy at the Hallinckrodt Institute of Radiology between 1967 and 1988. Of these patients 298 (42%) were found to have a recurrence; 70 (10%) experienced a local recurrence as the first site of recurrence without synchronous distant metastasis; 93 (13%) experienced synchronous local recurrence and distant metastasis, while 135 (19%) reported distant metastasis as the first site of recurrence. The diagnosis of local recurrence was by biopsy in 27 patients while the others were based on clinical evidence. Salvage treatment is as follows: 12 TUR, 1 implant, 3 chemotherapy, 23 orchiectomy, 20 hormones, 2 external radiotherapy and 9 others. Results: The median survival, from time of recurrence, for all patients was 2.75 years, with a 5, 8, and 10 years probability of survival of 25X, 12X, and 7.5X, respectively. For those who experienced a local recurrence as the first site of recurrence without synchronous distant metastasis the 5, 8, 10 year probability of survival was 48X, 27X, and 18X, respectively. The time of recurrence after initial radiotherapy affects significantly subsequent survival; the 5-year actuarial survival from the time of who recurred within 2 years, 3-5 years, recurrence, for local recurrence was 21X, 47% and 94X, for those and more than 5 years, respectively. The time of recurrence did not affect subsequent patient survival when distant metastasis is involved. Initial stage influenced survival after patient experienced a local recurrence; the [j-year survival for patients who experienced a local recurrence with initial stage B disease was 71% as opposed to 36% for patients with an initial stage C disease. Initial histological grade did not affect patient survival who experienced a local recurrence; 5-year survival from time of recurrence was 49X, 46X, and 47% for those with initial well, moderately, and poorly differentiated histology. Patients with a local recurrence without synchronous distant metastasis after Conclusion: definitive radiotherapy is associated with a favorable prognosis compared to those with distant The factors that effect subsequent patient survival after they experienced a local metastasis. recurrence include initial stage and time of recurrence, while initial histologic grade has no influence on subsequent patient survival after local recurrence.
74 THE PROGNOSTIC SIGNIFICANCE? OF RACE AND SURVIVAL PROM PROSTATE CANCER BASED ON RTOG RANDOMIZED TRIALS 7506, 7706, AND 8307 Mack Roach III, M.D.l, Minhce Won, M.A.2, James W.Kel1e.r. M.D.3, William T. Sause, M.D.5, R.L. Scotte Doggett, M.D.6, Marvin Rotman, Miljenko V.Pilepich, M.D.9, Sucha 0. Asbell, M.D. lo
Carlos A.Perez, M.D.4 , M.D.7, Russ Homer, M.D.8,
‘Department of Radiaton Oncolo~,y, University of California, San Francisco CA ; *The Radiaton Therapy Oncology ; 3University of Rochester. Rochester NY : 4Washington University. St.Louis, MO
Headquarters. Philedelphia, PA Hospital, Salt Lake City, UT
9C.MCAuley
; 6R:ldiation
Oncology Center Sacramento CA, 7SUNY/F3rooklyn. NY
Health Center Ann Arbor. MI ;l” Albert Einstein.
Phildelphia,
;
Group
;
5LDS
8Marshfield Clinic, WIS.
:
PA
To evaluate the prognostic significance of race and survival from prostate cancer using data from DrosDective randomized RTOCi trials 7506, 7706 and 8307 and MethPds; From 1976 to 1985, >1200 patients were entered on three RTOG prospective randomized trials for prostate cancer. Approximately 10% of the patients entered on these trials were coded as Black while nearly all of the Protocol 7706 included 484 patients with clinical stage A2 or B who remaining patients were coded as White. Only patients without were randomized to receive prostate irradiation only or pelvic plus prostate irradiation. Protocol 7506 included 607 patients with stage C or evidence of node involvement were included in this study.