open access

Vol 25, No 1 (2020)
Original research articles
Published online: 2020-01-01
Submitted: 2019-05-28
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Positive prostate biopsy following radiotherapy can predict metastasis-free survival in localized prostate cancer

A. Zapatero, M. Adrados, L. Torres, M.S. Talaya, A. Cruz Conde, C. Martin de Vidales, L. Vega Piris, C. Olivier, M.T. Murillo
DOI: 10.1016/j.rpor.2019.12.003
·
Rep Pract Oncol Radiother 2020;25(1):55-59.

open access

Vol 25, No 1 (2020)
Original research articles
Published online: 2020-01-01
Submitted: 2019-05-28

Abstract

Background/aim(s)

To determine the impact of post-treatment biopsy results on 10-year metastasis-free survival (MFS), overall survival (OS) and cause-specific survival (CSS) in localized prostate cancer (PCa) patients treated with high-dose radiotherapy (RT).

Materials/Methods

Retrospective analysis of 232 patients with T1c-T3bN0M0 PCa who underwent a prostate biopsy 24–36 months after high-dose RT. Biopsies were categorized as positive biopsy (PB) if H&E staining showed evidence of residual malignancy and negative biopsy (NB) if no malignant cells were present. Kaplan-Meier estimates of 10-year MFS, OS and CSS rates were calculated for each group and Cox proportional-hazards models were used to estimate the hazard ratios. The median follow-up was 124 months (range 26–267).

Results

Sixty-two of 232 (26.7%) patients had post-treatment positive biopsies (PB). A positive post-treatment biopsy was significantly associated with a lower 10-year MFS (78.4% vs. 95.4%, p = 0.001, HR: 3.9, 95% CI: 1.8–8.3). Although patients with PB had worse outcomes that those with NB, we could not show a statistically significant difference in OS (81.0% vs. 87.9%, p = 0.282, HR: 1.3, 95% CI: 0.7–2.3) or CSS (96.2% vs. 99.4% (p = 0.201, HR. 2.4, 95% CI: 0.6–9.7). After multivariate analysis, the strongest predictor of MFS was the post-treatment biopsy status (p < 0.001, HR: 5.4, 95% CI 2.26–12.85) followed by Gleason score (p = 0.002, HR: 2.24, 95% CI 1.33–3.79).

Conclusion

A positive biopsy following RT can predict MFS in localized prostate cancer. These data highlight the relevance of achieving a local control and support the use of aggressive local therapeutic interventions for PCa.

Abstract

Background/aim(s)

To determine the impact of post-treatment biopsy results on 10-year metastasis-free survival (MFS), overall survival (OS) and cause-specific survival (CSS) in localized prostate cancer (PCa) patients treated with high-dose radiotherapy (RT).

Materials/Methods

Retrospective analysis of 232 patients with T1c-T3bN0M0 PCa who underwent a prostate biopsy 24–36 months after high-dose RT. Biopsies were categorized as positive biopsy (PB) if H&E staining showed evidence of residual malignancy and negative biopsy (NB) if no malignant cells were present. Kaplan-Meier estimates of 10-year MFS, OS and CSS rates were calculated for each group and Cox proportional-hazards models were used to estimate the hazard ratios. The median follow-up was 124 months (range 26–267).

Results

Sixty-two of 232 (26.7%) patients had post-treatment positive biopsies (PB). A positive post-treatment biopsy was significantly associated with a lower 10-year MFS (78.4% vs. 95.4%, p = 0.001, HR: 3.9, 95% CI: 1.8–8.3). Although patients with PB had worse outcomes that those with NB, we could not show a statistically significant difference in OS (81.0% vs. 87.9%, p = 0.282, HR: 1.3, 95% CI: 0.7–2.3) or CSS (96.2% vs. 99.4% (p = 0.201, HR. 2.4, 95% CI: 0.6–9.7). After multivariate analysis, the strongest predictor of MFS was the post-treatment biopsy status (p < 0.001, HR: 5.4, 95% CI 2.26–12.85) followed by Gleason score (p = 0.002, HR: 2.24, 95% CI 1.33–3.79).

Conclusion

A positive biopsy following RT can predict MFS in localized prostate cancer. These data highlight the relevance of achieving a local control and support the use of aggressive local therapeutic interventions for PCa.

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Keywords

Prostate cancer; Biopsy; Post-treatment; Radiation therapy; Intensity-modulated radiotherapy; Survival

About this article
Title

Positive prostate biopsy following radiotherapy can predict metastasis-free survival in localized prostate cancer

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 25, No 1 (2020)

Pages

55-59

Published online

2020-01-01

DOI

10.1016/j.rpor.2019.12.003

Bibliographic record

Rep Pract Oncol Radiother 2020;25(1):55-59.

Keywords

Prostate cancer
Biopsy
Post-treatment
Radiation therapy
Intensity-modulated radiotherapy
Survival

Authors

A. Zapatero
M. Adrados
L. Torres
M.S. Talaya
A. Cruz Conde
C. Martin de Vidales
L. Vega Piris
C. Olivier
M.T. Murillo

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