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Re-stratification of Patients with High-Risk Prostate Cancer According to the NCCN Guidelines among Patients Who Underwent Radical Prostatectomy: An Analysis Based on the K-CaP Registry
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Kwang Suk Lee, Kyo Chul Koo, In Young Choi, Ji Youl Lee, Jun Hyuk Hong, Choung-Soo Kim, Hyun Moo Lee, Sung Kyu Hong, Seok-Soo Byun, Koon Ho Rha, Byung Ha Chung
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Cancer Res Treat. 2018;50(1):88-94. Published online March 7, 2017
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DOI: https://doi.org/10.4143/crt.2016.494
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 Abstract
 PDF PubReader ePub
- Purpose
The present study aimed to re-stratify patients with high-risk prostate cancer according to the National Comprehensive Cancer Network guidelines among patients who underwent radical prostatectomy (RP).
Materials and Methods
This study used the Korean Prostate Cancer Database registry and identified 1,060 patients with high-risk prostate cancer who underwent RP between May 2001 and April 2013. All patients were categorized into risk groups, and subgroups were identified according to the type and number of high-risk factors.
Results
Of the 1,060 high-risk patients, 599 (56.5%), 408 (38.5%), and 53 (5.0%) had 1, 2, and 3 risk factors, respectively. In multivariate analysis, the Gleason score, percentage of positive biopsy cores, and number of risk factors present were identified as independent predictors of biochemical recurrence. There were significant differences in the 5-year postoperative biochemical failure-free survival (BCFFS) rate among the different high-risk factor subgroups (log-rank p < 0.001). There were no significant differences in the BCFFS rate between the subgroup of high-risk patients with a prostate-specific antigen level > 20 ng/mL alone and the intermediate-risk group with all factors (log-rank p=0.919 and p=0.781, respectively). Additionally, no significant differencewas noted in the BCFFS rate between high-risk patients having all factors and those in the very-high-risk group (p=0.566).
Conclusion
We successfully re-stratified patients with high-risk prostate cancer and identified the combinations of high-risk criteria that will help in the selection of patients for RP.
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Citations
Citations to this article as recorded by  - Prostate‑specific antigen density and preoperative MRI findings as predictors of biochemical recurrence in high‑risk and very high‑risk prostate cancer
Cheng-Kuang Yang, Chi-Rei Yang, Yen-Chuan Ou, Chen-Li Cheng, Hao-Chung Ho, Kun-Yuan Chiu, Shian-Shiang Wang, Jian-Ri Li, Chuan-Shu Chen, Chi-Feng Hung, Cheng-Che Chen, Shu-Chi Wang, Chia-Yen Lin, Sheng-Chun Hung
Oncology Letters.2023;[Epub] CrossRef - Comparison of the clinicopathologic features of prostate cancer in US and Chinese populations
Lei Zhang, Xiaoyan Liu, Rong Xia, Fei Chen, Xin Wang, Jia Bao, Yongzhao Shao, Xian Lu, Yan Wang, Jili Wang, May Thu Tun, Jonathan Melamed, Hebert Lepor, Fang-Ming Deng, Dongwen Wang, Guoping Ren
Pathology - Research and Practice.2022; 234: 153933. CrossRef - Ten-Year Results From a Phase II Study on Image Guided, Intensity Modulated Radiation Therapy With Simultaneous Integrated Boost in High-Risk Prostate Cancer
Christian Ekanger, Svein Inge Helle, Daniel Heinrich, Dag Clement Johannessen, Ása Karlsdóttir, Yngve Nygård, Ole Johan Halvorsen, Lars Reisæter, Rune Kvåle, Liv Bolstad Hysing, Olav Dahl
Advances in Radiation Oncology.2020; 5(3): 396. CrossRef
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Cancer-Specific Mortality Among Korean Men with Localized or Locally Advanced Prostate Cancer Treated with Radical Prostatectomy Versus Radiotherapy: A Multi-Center Study Using Propensity Scoring and Competing Risk Regression Analyses
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Kyo Chul Koo, Jin Seon Cho, Woo Jin Bang, Seung Hwan Lee, Sung Yong Cho, Sun Il Kim, Se Joong Kim, Koon Ho Rha, Sung Joon Hong, Byung Ha Chung
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Cancer Res Treat. 2018;50(1):129-137. Published online March 8, 2017
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DOI: https://doi.org/10.4143/crt.2017.004
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Abstract
PDFPubReaderePub
- Purpose
Studies comparing radical prostatectomy (RP) outcomes with those of radiotherapy with or without androgen deprivation therapy (RT±ADT) for prostate cancer (PCa) have yielded conflicting results. Therefore, we used propensity score-matched analysis and competing risk regression analysis to compare cancer-specific mortality (CSM) and other-cause mortality (OCM) between these two treatments.
Materials and Methods
The multi-center, Severance Urological Oncology Group registry was utilized to identify 3,028 patients with clinically localized or locally advanced PCa treated by RP (n=2,521) or RT±ADT (n=507) between 2000 and 2016. RT±ADT cases (n=339) were matched with an equal number of RP cases by propensity scoring based on age, preoperative prostate-specific antigen, clinical tumor stage, biopsy Gleason score, and Charlson Comorbidity Index (CCI). CSM and OCM were co-primary endpoints.
Results
Median follow-up was 65.0 months. Five-year overall survival rates for patients treated with RP and RT±ADT were 94.7% and 92.0%, respectively (p=0.105). Cumulative incidence estimates revealed comparable CSM rates following both treatments within all National Comprehensive Cancer Network risk groups. Gleason score ≥ 8 was associated with higher risk of CSM (p=0.009). OCM rates were comparable between both groups in the low- and intermediate-risk categories (p=0.354 and p=0.643, respectively). For high-risk patients, RT±ADT resulted in higher OCM rates than RP (p=0.011). Predictors of OCM were age ≥ 75 years (p=0.002) and CCI ≥ 2 (p < 0.001).
Conclusion
RP and RT±ADT provide comparable CSM outcomes in patients with localized or locally advanced PCa. The risk of OCM may be higher for older high-risk patients with significant comorbidities.
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Citations
Citations to this article as recorded by - Japanese clinical practice guidelines for prostate cancer 2023
Yasuo Kohjimoto, Hiroji Uemura, Masahiro Yoshida, Shiro Hinotsu, Satoru Takahashi, Tsutomu Takeuchi, Kazuhiro Suzuki, Hiroshi Shinmoto, Tsutomu Tamada, Takahiro Inoue, Mikio Sugimoto, Atsushi Takenaka, Tomonori Habuchi, Hitoshi Ishikawa, Takashi Mizowaki,
International Journal of Urology.2024; 31(11): 1180. CrossRef - Radical prostatectomy versus external beam radiotherapy with androgen deprivation therapy for high-risk prostate cancer: a systematic review
Berdine L. Heesterman, Katja K. H. Aben, Igle Jan de Jong, Floris J. Pos, Olga L. van der Hel
BMC Cancer.2023;[Epub] CrossRef - Risk factors for prostate-specific antigen persistence in pT3aN0 prostate cancer after robot-assisted laparoscopic radical prostatectomy: a retrospective study
Jun Seop Kim, Jae Hoon Chung, Wan Song, Minyong Kang, Hyun Hwan Sung, Hwang Gyun Jeon, Byong Change Jeong, Seong Il Seo, Hyun Moo Lee, Seong Soo Jeon
Journal of Yeungnam Medical Science.2023; 40(4): 412. CrossRef - Comparison of contrast-enhanced ultrasound targeted biopsies versus standard systematic biopsies for prostate cancer correction in different PSA value groups in rural China
Dian Yuan Lu, Lan Liu, Li Shen, Jian Rong Cai, Li Xu, Li Hua Xiang
Clinical Hemorheology and Microcirculation.2021; 77(3): 295. CrossRef - Comparison of Radical Prostatectomy Versus Radiation and Androgen Deprivation Therapy Strategies as Primary Treatment for High-risk Localized Prostate Cancer: A Systematic Review and Meta-analysis
Benjamin A. Greenberger, Nicholas G. Zaorsky, Robert B. Den
European Urology Focus.2020; 6(2): 404. CrossRef - Long short-term memory artificial neural network model for prediction of prostate cancer survival outcomes according to initial treatment strategy: development of an online decision-making support system
Kyo Chul Koo, Kwang Suk Lee, Suah Kim, Choongki Min, Gyu Rang Min, Young Hwa Lee, Woong Kyu Han, Koon Ho Rha, Sung Joon Hong, Seung Choul Yang, Byung Ha Chung
World Journal of Urology.2020; 38(10): 2469. CrossRef - Comparing Radiotherapy to Prostatectomy for High-Risk Prostate Cancer
Benjamin A. Greenberger, James M. Taylor, Victor E. Chen, Robert B. Den
The Cancer Journal.2020; 26(1): 29. CrossRef - Outcomes of treatment for localized prostate cancer in a single institution: comparison of radical prostatectomy and radiation therapy by propensity score matching analysis
Narihiko Hayashi, Kimito Osaka, Kentaro Muraoka, Hisashi Hasumi, Kazuhide Makiyama, Keiichi Kondo, Noboru Nakaigawa, Masahiro Yao, Yuki Mukai, Madoka Sugiura, Shoko Takano, Eiko Ito, Hisashi Kaizu, Izumi Koike, Masaharu Hata, Masataka Taguri, Yasuhide Miy
World Journal of Urology.2020; 38(10): 2477. CrossRef - Benefits and Risks of Primary Treatments for High-risk Localized and Locally Advanced Prostate Cancer: An International Multidisciplinary Systematic Review
Lisa Moris, Marcus G. Cumberbatch, Thomas Van den Broeck, Giorgio Gandaglia, Nicola Fossati, Brian Kelly, Raj Pal, Erik Briers, Philip Cornford, Maria De Santis, Stefano Fanti, Silke Gillessen, Jeremy P. Grummet, Ann M. Henry, Thomas B.L. Lam, Michael Lar
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Satoru Taguchi, Kenshiro Shiraishi, Hiroshi Fukuhara
Japanese Journal of Clinical Oncology.2020; 50(9): 963. CrossRef - Comparing effectiveness of radical prostatectomy versus external beam radiotherapy in patients with locally advanced prostate cancer
Xianghong Zhou, Kun Jin, Shi Qiu, Di Jin, Xinyang Liao, Xiang Tu, Xiaonan Zheng, Jiakun Li, Lu Yang, Qiang Wei
Medicine.2020; 99(34): e21642. CrossRef - Robot or radiation? A qualitative study of the decision support needs of men with localised prostate cancer choosing between robotic prostatectomy and radiotherapy treatment
Allan ‘Ben’ Smith, Orlando Rincones, Mark Sidhom, Pascal Mancuso, Karen Wong, Megan Berry, Dion Forstner, Leslie Bokey, Afaf Girgis
Patient Education and Counseling.2019; 102(7): 1364. CrossRef - Elective pelvic irradiation in prostate cancer patients with biochemical failure following radical prostatectomy: A propensity score matching analysis
Changhoon Song, Sang Jun Byun, Young Seok Kim, Hanjong Ahn, Seok-Soo Byun, Choung-Soo Kim, Sang Eun Lee, Jae-Sung Kim, Christopher J.D. Wallis
PLOS ONE.2019; 14(4): e0215057. CrossRef - 125I low‑dose‑rate prostate brachytherapy and radical prostatectomy in patients with prostate cancer
Zhien Zhou, Weigang Yan, Yi Zhou, Fuquan Zhang, Hanzhong Li, Zhigang Ji
Oncology Letters.2019;[Epub] CrossRef - Time to Disease Recurrence Is a Predictor of Metastasis and Mortality in Patients with High-risk Prostate Cancer Who Achieved Undetectable Prostate-specific Antigen Following Robot-assisted Radical Prostatectomy
Do Kyung Kim, Kyo Chul Koo, Kwang Suk Lee, Yoon Soo Hah, Koon Ho Rha, Sung Joon Hong, Byung Ha Chung
Journal of Korean Medical Science.2018;[Epub] CrossRef
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