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• W2032248063 abstract "No AccessJournal of UrologyClinical Urology: Original Article1 Mar 1999DEOXYRIBONUCLEIC ACID PLOIDY AND SERUM PROSTATE SPECIFIC ANTIGEN PREDICT OUTCOME FOLLOWING SALVAGE PROSTATECTOMY FOR RADIATION REFRACTORY PROSTATE CANCER CHRISTOPHER L. AMLING, SETH E. LERNER, SANDRA K. MARTIN, JEFFREY M. SLEZAK, MICHAEL L. BLUTE, and HORST ZINCKE CHRISTOPHER L. AMLINGCHRISTOPHER L. AMLING More articles by this author , SETH E. LERNERSETH E. LERNER More articles by this author , SANDRA K. MARTINSANDRA K. MARTIN More articles by this author , JEFFREY M. SLEZAKJEFFREY M. SLEZAK More articles by this author , MICHAEL L. BLUTEMICHAEL L. BLUTE More articles by this author , and HORST ZINCKEHORST ZINCKE More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)61790-7AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We assessed clinical and pathological variables for the ability to predict improved outcome following salvage prostatectomy for radiation refractory prostate cancer. We identify factors that might assist in selection of candidates for this procedure. Materials and Methods: Between 1966 and 1996, 108 patients (mean age 64.7 years) underwent salvage radical retropubic prostatectomy for radiation refractory prostate cancer. Preoperative serum prostate specific antigen (PSA), available in 70 patients treated since 1987, was less than 4 in 19, 4 to 10 in 31 and greater than 10 ng./ml. in 20. Serum PSA before radiotherapy was available in 37 patients. Serum PSA before radiotherapy and salvage surgery, tumor grade, deoxyribonucleic acid (DNA) ploidy and margin status were analyzed for the ability to predict cancer specific and progression-free survival (local, systemic and PSA 0.2 ng./ml. or greater). Complication rates were compared between early (before 1990) and late (1990 to 1996) salvage prostatectomy groups. Results: Overall cancer specific and progression-free survival at 10 years was 70 and 44%, respectively. The pathological stage was pT2N0 in 39%, pT3-4N0 in 42% and pTxN+ in 19% of cases. DNA ploidy was predominately nondiploid, that is diploid in 25%, tetraploid in 64% and aneuploid in 11% of tumors. Although preoperative serum PSA was not predictive of pathological stage, patients with preoperative PSA less than 10 ng./ml. had better progression-free survival than those with higher levels (p = 0.05). DNA ploidy was the strongest predictor of cancer specific (p = 0.002) and progression-free (p = 0.002) survival. Controlling for grade and PSA using the Cox proportional hazards model, DNA ploidy remained a significant predictor of prostate cancer death (p <0.001) and disease progression (p <0.001). Complication rates improved somewhat in more recently treated patients but incontinence and bladder neck contracture rates remained significant. Conclusions: DNA ploidy and preoperative serum PSA appear to be the most important predictors of outcome following salvage prostatectomy for radiation refractory prostate cancer. Preoperative consideration of these factors may be helpful in selecting candidates for this procedure. References 1 : The American Cancer Society National Prostate Cancer Detection Project and national patterns of prostate cancer detection and treatment. CA Cancer J. Clin.1997; 47: 265. Google Scholar 2 : Radical radiation in the management of prostatic adenocarcinoma: the initial prostate specific antigen as a predictor of treatment outcome. J. Urol.1994; 151: 640. 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Google Scholar From the Department of Urology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota(ZINCKE) Requests for reprints: Department of Urology, Mayo Clinic, 200 First St., S.W., Rochester, Minnesota 55905.© 1999 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byLeibovici D, Chiong E, Pisters L, Guo C, Ward J, Andino L, Prokhorova I and Troncoso P (2012) Pathological Characteristics of Prostate Cancer Recurrence After Radiation Therapy: Implications for Focal Salvage TherapyJournal of Urology, VOL. 188, NO. 1, (98-102), Online publication date: 1-Jul-2012.Pisters L, Leibovici D, Blute M, Zincke H, Sebo T, Slezak J, Izawa J, Ward J, Scott S, Madsen L, Spiess P and Leibovich B (2009) Locally Recurrent Prostate Cancer After Initial Radiation Therapy: A Comparison of Salvage Radical Prostatectomy Versus CryotherapyJournal of Urology, VOL. 182, NO. 2, (517-527), Online publication date: 1-Aug-2009.Babaian R, Donnelly B, Bahn D, Baust J, Dineen M, Ellis D, Katz A, Pisters L, Rukstalis D, Shinohara K and Thrasher J (2008) Best Practice Statement on Cryosurgery for the Treatment of Localized Prostate CancerJournal of Urology, VOL. 180, NO. 5, (1993-2004), Online publication date: 1-Nov-2008.De E, Pisters L, Pettaway C, Scott S and Westney O (2018) Salvage Prostatectomy With Bladder Neck Closure, Continent Catheterizable Stoma and Bladder Augmentation: Feasibility and Patient Reported Continence Outcomes at 32 MonthsJournal of Urology, VOL. 177, NO. 6, (2200-2204), Online publication date: 1-Jun-2007.TOUMA N, IZAWA J and CHIN J (2018) CURRENT STATUS OF LOCAL SALVAGE THERAPIES FOLLOWING RADIATION FAILURE FOR PROSTATE CANCERJournal of Urology, VOL. 173, NO. 2, (373-379), Online publication date: 1-Feb-2005.STEPHENSON A, SCARDINO P, BIANCO F, DiBLASIO C, FEARN P and EASTHAM J (2018) MORBIDITY AND FUNCTIONAL OUTCOMES OF SALVAGE RADICAL PROSTATECTOMY FOR LOCALLY RECURRENT PROSTATE CANCER AFTER RADIATION THERAPYJournal of Urology, VOL. 172, NO. 6 Part 1, (2239-2243), Online publication date: 1-Dec-2004.GHAFAR M, JOHNSON C, DE LA TAILLE A, BENSON M, BAGIELLA E, FATAL M, OLSSON C and KATZ A (2018) SALVAGE CRYOTHERAPY USING AN ARGON BASED SYSTEM FOR LOCALLY RECURRENT PROSTATE CANCER AFTER RADIATION THERAPY: THE COLUMBIA EXPERIENCEJournal of Urology, VOL. 166, NO. 4, (1333-1338), Online publication date: 1-Oct-2001. (2018) EDITORIAL COMMENTJournal of Urology, VOL. 165, NO. 6 Part 1, (1941-1942), Online publication date: 1-Jun-2001.IZAWA J, AJAM K, McGUIRE E, SCOTT S, von ESCHENBACH A, SKIBBER J and PISTERS L (2018) MAJOR SURGERY TO MANAGE DEFINITIVELY SEVERE COMPLICATIONS OF SALVAGE CRYOTHERAPY FOR PROSTATE CANCERJournal of Urology, VOL. 164, NO. 6, (1978-1981), Online publication date: 1-Dec-2000.BRINKER D, ROSS J, TRAN T, JONES D and EPSTEIN J (2018) CAN PLOIDY OF PROSTATE CARCINOMA DIAGNOSED ON NEEDLE BIOPSY PREDICT RADICAL PROSTATECTOMY STAGE AND GRADE?Journal of Urology, VOL. 162, NO. 6, (2036-2039), Online publication date: 1-Dec-1999. Volume 161Issue 3March 1999Page: 857-863 Advertisement Copyright & Permissions© 1999 by American Urological Association, Inc.MetricsAuthor Information CHRISTOPHER L. AMLING More articles by this author SETH E. LERNER More articles by this author SANDRA K. MARTIN More articles by this author JEFFREY M. SLEZAK More articles by this author MICHAEL L. BLUTE More articles by this author HORST ZINCKE More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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