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Radiation Oncology

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Open Access 01-12-2012 | Research

The role of the maximum involvement of biopsy core in predicting outcome for patients treated with dose-escalated radiation therapy for prostate cancer

Authors: Jure Murgic, Matthew H Stenmark, Schuyler Halverson, Kevin Blas, Felix Y Feng, Daniel A Hamstra

Published in: Radiation Oncology | Issue 1/2012

Abstract

Purpose

To evaluate the influence of the maximum involvement of biopsy core (MIBC) on outcome for prostate cancer patients treated with dose-escalated external beam radiotherapy (EBRT).

Methods and materials

The outcomes of 590 men with localized prostate cancer treated with EBRT (≥75 Gy) at a single institution were retrospectively analyzed. The influence of MIBC on freedom from biochemical failure (FFBF), freedom from metastasis (FFM), cause-specific survival (CSS), and overall survival (OS) was compared to other surrogates for biopsy tumor volume, including the percentage of positive biopsy cores (PPC) and the total percentage of cancer volume (PCV).

Results

MIBC correlated with PSA, T-stage, Gleason score, NCCN risk group, PPC, PCV, and treatment related factors. On univariate analysis, MIBC was prognostic for all endpoints except OS; with greatest impact in those with Gleason scores of 8–10. However, on multivariate analysis, MIBC was only prognostic for FFBF (hazard ratio [HR] 1.9, p = 0.008), but not for FFM (p = 0.19), CSS (p = 0.16), and OS (p = 0.99).

Conclusions

In patients undergoing dose-escalated EBRT, MIBC had the greatest influence in those with Gleason scores of 8–10 but provided no additional prognostic data as compared to PPC and PCV, which remain the preferable prognostic variables in this patient population.

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D'Amico AV, Whittington R, Malkowicz SB, Schultz D, Blank K, Broderick GA, Tomaszewski JE, Renshaw AA, Kaplan I, Beard CJ, et al.: Biochemical Outcome After Radical Prostatectomy, External Beam Radiation Therapy, or Interstitial Radiation Therapy for Clinically Localized Prostate Cancer. JAMA 1998,280(11):969-974. 10.1001/jama.280.11.969CrossRefPubMed

Bahnson RR, Hanks GE, Huben RP, Kantoff P, Kozlowski JM, Kuettel M, Lange PH, Logothetis C, Pow-Sang JM, Roach M, et al.: NCCN Practice Guidelines for Prostate Cancer. Oncology (Williston Park, NY) 2000,14(11):111-119.

D'Amico AV, Schultz D, Silver B, Henry L, Hurwitz M, Kaplan I, Beard CJ, Renshaw AA: The clinical utility of the percent of positive prostate biopsies in predicting biochemical outcome following external-beam radiation therapy for patients with clinically localized prostate cancer. Int J Radiat Oncol Biol Phys 2001,49(3):679-684. 10.1016/S0360-3016(00)01423-1CrossRefPubMed

Wong WW, Schild SE, Vora SA, Halyard MY: Association of percent positive prostate biopsies and perineural invasion with biochemical outcome after external beam radiotherapy for localized prostate cancer. Int J Radiat Oncol Biol Phys 2004,60(1):24-29. 10.1016/j.ijrobp.2004.02.031CrossRefPubMed

Spalding AC, Daignault S, Sandler HM, Shah RB, Pan CC, Ray ME: Percent positive biopsy cores as a prognostic factor for prostate cancer treated with external beam radiation. Urology 2007,69(5):936-940. 10.1016/j.urology.2007.01.066CrossRefPubMed

Qian Y, Feng FY, Halverson S, Blas K, Sandler HM, Hamstra DA: The percent of positive biopsy cores improves prediction of prostate cancer-specific death in patients treated with dose-escalated radiotherapy. Int J Radiat Oncol Biol Phys 2011,81(3):e135-142. 10.1016/j.ijrobp.2011.01.007CrossRefPubMed

Buyyounouski MK, Hanlon AL, Horwitz EM, Pollack A: Interval to biochemical failure highly prognostic for distant metastasis and prostate cancer-specific mortality after radiotherapy. Int J Radiat Oncol Biol Phys 2008,70(1):59-66. 10.1016/j.ijrobp.2007.05.047CrossRefPubMed

Vance SM, Stenmark MH, Blas K, Halverson S: Hamstra DA. Feng FY: Percentage of Cancer Volume in Biopsy Cores is Prognostic for Prostate Cancer Death and Overall Survival in Patients Treated with Dose-Escalated External Beam Radiotherapy. Int J Radiat Oncol Biol Phys; 2011.

Venkitaraman R, Norman A, Woode-Amissah R, Fisher C, Dearnaley D, Horwich A, Huddart R, Khoo V, Thompson A, Parker C: Predictors of histological disease progression in untreated, localized prostate cancer. J Urol 2007,178(3 Pt 1):833-837.CrossRefPubMed

10.

Brimo F, Vollmer RT, Corcos J, Kotar K, Begin LR, Humphrey PA, Bismar TA: Prognostic value of various morphometric measurements of tumour extent in prostate needle core tissue. Histopathology 2008,53(2):177-183. 10.1111/j.1365-2559.2008.03087.xCrossRefPubMed

11.

Huang J, Vicini FA, Williams SG, Ye H, McGrath S, Ghilezan M, Krauss D, Martinez AA, Kestin LL: Percentage of Positive Biopsy Cores. Int J Radiat Oncol Biol Phys: A Better Risk Stratification Model for Prostate Cancer?; 2011.

Title: The role of the maximum involvement of biopsy core in predicting outcome for patients treated with dose-escalated radiation therapy for prostate cancer
Authors: Jure Murgic
Matthew H Stenmark
Schuyler Halverson
Kevin Blas
Felix Y Feng
Daniel A Hamstra
Publication date: 01-12-2012
Publisher: BioMed Central
Published in: Radiation Oncology / Issue 1/2012
Electronic ISSN: 1748-717X
DOI: https://doi.org/10.1186/1748-717X-7-127

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The role of the maximum involvement of biopsy core in predicting outcome for patients treated with dose-escalated radiation therapy for prostate cancer

Abstract

Purpose

Methods and materials

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods and materials

Results

Conclusions

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