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- Title
Natural History of Untreated Prostate Specific Antigen Radio recurrent Prostate Cancer in Men with Favorable Prognostic Indicators.
- Authors
Martin, Neil E.; Ming-Hui Chen; Beard, Clair J.; Nguyen, Paul L.; Loffredo, Marian J.; Renshaw, Andrew A.; Kantoff, Philip W.; D'Amico, Anthony V.
- Abstract
Background and Purpose. Life expectancy data could identify men with favorable post-radiation prostate-specific antigen (PSA) failure kinetics unlikely to require androgen deprivation therapy (ADT). Materials and Methods. Of 206menwith unfavorable-risk prostate cancer in a randomized trial of radiation versus radiation and ADT, 53 experienced a PSA failure and were followed without salvage ADT. Comorbidity, age and established prognostic factors were assessed for relationship to death using Cox regression analyses. Results. The median age at failure, interval to PSA failure, and PSA doubling time were 76.6 years (interquartile range [IQR]: 71.8-79.3), 49.1 months (IQR: 37.7-87.4), and 25 months (IQR: 13.1-42.8), respectively. After a median follow up of 4.0 years following PSA failure, 45% of men had died, none from prostate cancer and no one had developed metastases. Both increasing age at PSA failure (HR: 1.14; 95% CI: 1.03-1.25; p = 0.008) and the presence of moderate to severe comorbidity (HR: 12.5; 95% CI: 3.81-41.0; p < 0.001) were significantly associated with an increased risk of death. Conclusions. Men over the age of 76 with significant comorbidity and a PSA doubling time >2 years following post-radiation PSA failure appear to be good candidates for observation without ADT intervention.
- Subjects
PROSTATE-specific antigen; PROSTATE cancer prognosis; CANCER in men; CANCER relapse; LIFE expectancy; CANCER radiotherapy; CANCER-related mortality; HISTORY
- Publication
Prostate Cancer (20903111), 2014, p1
- ISSN
2090-3111
- Publication type
Article
- DOI
10.1155/2014/912943