Biopsy diagnosis of intraductal carcinoma is prognostic in intermediate and high risk prostate cancer patients treated by radiotherapy.

Details

Serval ID
serval:BIB_3810FB48D013
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Biopsy diagnosis of intraductal carcinoma is prognostic in intermediate and high risk prostate cancer patients treated by radiotherapy.
Journal
European Journal of Cancer
Author(s)
Van der Kwast T., Al Daoud N., Collette L., Sykes J., Thoms J., Milosevic M., Bristow R.G., Van Tienhoven G., Warde P., Mirimanoff R.O., Bolla M.
ISSN
1879-0852 (Electronic)
ISSN-L
0959-8049
Publication state
Published
Issued date
2012
Volume
48
Number
9
Pages
1318-1325
Language
english
Notes
Publication types: Clinical Trial, Phase III ; Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Abstract
AIM: We investigated the prognostic significance of intraductal carcinoma of the prostate (IDC-P) in biopsies and transurethral resections prior to external beam radiotherapy with or without androgen deprivation.
METHODS: Cohort 1 consisted of 118 intermediate risk prostate cancer patients treated by radiotherapy, with biochemical relapse as primary end-point (median follow-up 6.5 years). Cohort 2 consisted of 132 high risk patients, enrolled in a phase III randomised trial (EORTC 22863) comparing radiotherapy alone to radiotherapy with long-term androgen deprivation (LTAD) with clinical progression free survival as primary end-point (median follow-up 9.1 years). Presence of IDC-P was identified after central review. Multivariable regression modelling and Kaplan-Meier analysis were performed with IDC-P as dichotomous variable.
RESULTS: IDC-P was a strong prognosticator for early (<36 months) biochemical relapse (HR 7.3; p = 0.007) in cohort 1 and for clinical disease-free survival in both arms of cohort 2 (radiotherapy arm: HR 3.5; p < 0.0001; radiotherapy plus LTAD arm: HR 2.8, p = 0.018). IDC-P retained significance after stratification for reviewed Gleason score in the radiotherapy arm (HR 2.3; p = 0.03). IDC-P was a strong prognosticator for metastatic failure rate (radiotherapy arm: HR 5.3; p < 0.0001; radiotherapy plus LTAD arm: HR 3.6; p = 0.05).
CONCLUSIONS: IDC-P in diagnostic samples of patients with intermediate or high risk prostate cancer is an independent prognosticator of early biochemical relapse and metastatic failure rate after radiotherapy. We suggest that the presence of IDC-P in prostate biopsies should routinely be reported.
Keywords
Aged, Aged, 80 and over, Biopsy/methods, Carcinoma, Intraductal, Noninfiltrating/diagnosis, Carcinoma, Intraductal, Noninfiltrating/pathology, Cohort Studies, Disease-Free Survival, Follow-Up Studies, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Neoplasm Grading, Prostatic Neoplasms/diagnosis, Prostatic Neoplasms/pathology, Risk Factors, Treatment Outcome
Pubmed
Web of science
Create date
09/06/2012 17:55
Last modification date
20/08/2019 13:26
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