Prognostic factors in postoperative radiotherapy for prostate cancer – tertiary center experience
, , , , , , , , et | 25 mars 2021
À propos de cet article
Article Category: Research Article
Publié en ligne: 25 mars 2021
Pages: 203 - 211
Reçu: 20 nov. 2020
Accepté: 06 févr. 2021
DOI: https://doi.org/10.2478/raon-2021-0017
© 2021 Marcin Miszczyk, Wojciech Majewski, Konrad Stawiski, Konrad Rasławski, Paweł Rajwa, Iwona Jabłońska, Łukasz Magrowski, Oliwia Masri, Andrzej Paradysz, Leszek Miszczyk, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
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Univariate and multivariate analysis
| Univariate analysis | Multivariate analysis | |||||||
|---|---|---|---|---|---|---|---|---|
| DFS | BC | DFS | BC | |||||
| Covariate: | HR (95% CI) | p-value | HR (95% CI) | p-value | HR (95% CI) | p-value | HR (95% CI) | p-value |
| Age | 0.99 (0.94, 1.04) | 0.59 | 1.03 (0.99, 1.08) | 0.14 | 0.97 (0.92, 1.02) | 0.19 | 1.02 (0.98, 1.07) | 0.34 |
| max PSA prior to operation | 1.03 (0.97, 1.08) | 0.35 | 1.03 (1, 1.07) | 0.078 | 1.04 (0.97, 1.11) | 0.25 | 1.05 (1.02, 1.08) | |
| max PSA post operation | 1 (0.96, 1.05) | 0.91 | 1.04 (1.02, 1.05) | 0.53 (0.28, 1.01) | 0.052 | 1 (0.99, 1.02) | 0.65 | |
| PSA before radiotherapy | 1.24 (1.12, 1.37) | 1.26 (1.17, 1.35) | 2.17 (1.04, 4.55) | 1.19 (1.03, 1.38) | ||||
| ADT prior to RT | 1.42 (0.74, 2.74) | 0.29 | 1.06 (0.64, 1.75) | 0.82 | 1.39 (0.69, 2.77) | 0.35 | 0.82 (0.5, 1.35) | 0.43 |
| pT3a-b vs. pT2a-c | 2.57 (1.29, 5.1) | 1.35 (0.83, 2.19) | 0.23 | 4.29 (1.8, 10.25) | 1.89 (1.02, 3.5) | |||
| pN0 vs pN1 | 0.58 (0.16, 2.13) | 0.42 | 0.94 (0.3, 2.99) | 0.92 | 0.82 (0.31, 2.19) | 0.69 | 0.98 (0.56, 1.72) | 0.95 |
| aRT indication - R1 | 0.6 (0.27, 1.31) | 0.2 | 0.36 (0.2, 0.64) | 0.81 (0.19, 3.52) | 0.78 | 0.21 (0.09, 0.52) | ||
| aRT indication - pT3a-b | 1.45 (0.69, 3.04) | 0.33 | 0.86 (0.48, 1.55) | 0.62 | 0.72 (0.18, 2.89) | 0.64 | 1.04 (0.43, 2.53) | 0.93 |
| sRT indication - biochemical failure | 1.31 (0.64, 2.68) | 0.46 | 2.02 (1.17, 3.49) | 1.95 (0.41, 9.27) | 0.4 | 1.12 (0.52, 2.41) | 0.77 | |
| sRT indication - local failure | 2.03 (1.06, 3.89) | 2.36 (1.45, 3.84) | 2.39 (1.11, 5.15) | 1.48 (0.77, 2.83) | 0.24 | |||
| R1 operation (regardless of RT indication) | 1.2 (0.61, 2.35) | 0.59 | 0.82 (0.5, 1.32) | 0.41 | 1.52 (0.59, 3.92) | 0.38 | 2.17 (1.23, 3.84) | |
| PSA nadir (per 1ng/ml) | 1.34 (1.2, 1.5) | 1.29 (1.19, 1.39) | 1.16 (0.93, 1.46) | 0.19 | 1.37 (1.28, 1.46) | |||
| Gleason Grade Group | 1.4 (1.09, 1.8) | 1.15 (0.96, 1.38) | 0.12 | 1.28 (0.95, 1.73) | 0.1 | 1.13 (0.93, 1.38) | 0.23 | |
Description of the study group
| Whole group | aRT | sRT | |||
|---|---|---|---|---|---|
| Number of cases | 236 | 113 | 123 | ||
| Age* | 63.6 (59.8-68.4) | 62.3 (58.8-65.9) | 65.2 (60.5-70.2) | ||
| Time from surgery to RT (months)* | 6 (3.3-25.8) | 3.6 (2.9-4.8) | 24.1 (7.3-48.3) | ||
| Indication | n/a | R11 56 | pT32 57 | BCR3 69 | LF4 54 |
| Positive surgical margins | 61.5% | 100% | 77.2% | 39.1% | 27.8% |
| Max PSA pre-op* (ng/ml) | 9.16 (6.81-14.6) | 8.24 (6.33-11.78) | 9.37 (7.19-14.79) | 10.67 (7.3-17) | 8.8 (6.6-13.3) |
| Max PSA post-op*5 (ng/ml) | 0.27 (0.04-1.13) | 0.035 (<0.008-0.071) | 0.027 (<0.008-0.104) | 0.72 (0.38-1.92) | 1.19 (0.45 – 2.89) |
| PSA before RT* (ng/ml) | 0.2 (0.023-0.78) | 0.015 (<0.008-0.055) | 0.017 (<0.008-0.077) | 0.56 (0.29-1.07) | 1.05 (0.35-2.38) |
| 1 | 42.2% | 47.3% | 26.3% | 39.7% | 57.7% |
| 2 | 33.6% | 38.2% | 40.4% | 32.3% | 23.1% |
| 3 | 13.4% | 9.1% | 15.8% | 16.2% | 11.5% |
| 4 | 5.6% | 1.8% | 7% | 7.4% | 5.8% |
| 5 | 5.2% | 3.6% | 10.5% | 4.4% | 1.9% |
| pT2a-c | 61.6% | 100% | 0% | 63.6% | 84.3% |
| pT3a | 17.5% | 0% | 50.9% | 12.1% | 7.8% |
| pT3b | 21% | 0% | 49.1% | 24.2% | 7.8% |
| pN1 | 5.8% | 1.8% | 16.4% | 1.5% | 4% |
| ADT prior to RT | 37.6% | 16.4% | 43.9% | 42.6% | 46.3% |
| RT dose^ | 70 / 71.5 | 70 / 70.3 | 70 / 70.2 | 70 / 71.4 | 76 / 74.4 |
| Lymph node irradiation | 25.8% | 15% | 47.8% | 12.7% | 23.1% |