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- W2942223913 abstract "You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History II (MP41)1 Apr 2019MP41-10 SURVIVAL OUTCOMES OF INITIAL LOCAL THERAPY ON CLINICALLY LOCALIZED GLEASON 9-10 PROSTATE CANCER: A SURVEILLANCE, EPIDEMIOLOGY, AND END RESULTS DATABASE ANALYSIS Amy Nemirovsky*, Hubert Huang, Michael Naslund, and M. Minhaj Siddiqui Amy Nemirovsky*Amy Nemirovsky* More articles by this author , Hubert HuangHubert Huang More articles by this author , Michael NaslundMichael Naslund More articles by this author , and M. Minhaj SiddiquiM. Minhaj Siddiqui More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000556193.07993.c2AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Men with Gleason score 9-10 prostate cancer have significantly worse outcomes compared to those with Gleason score 8 disease. Choice of upfront treatments remain controversial for this patient cohort. Using the Surveillance, Epidemiology, and End Results (SEER) database, we evaluated the impact of initial treatment with external beam radiation therapy (EBRT), external beam radiation therapy with brachytherapy (EBRT+BT), or surgery on prostate cancer-specific mortality (PCSM) and overall mortality in Gleason 9-10 disease. METHODS: The SEER database was queried for men diagnosed with biopsy Gleason score 9-10 prostate cancer from 2004-2014. Only localized disease with clinical N0 and M0 status was included. Gathered data included demographic, pathologic, therapy received, and survival outcomes. Using JMP v11.0, Kaplan-Meier survival curves and univariate and multivariate analyses were generated for initial therapy with EBRT, EBRT+BT, or surgery. RESULTS: A total of 8,796 men were included with 4,988 (56.7%) who underwent upfront treatment with EBRT alone, 677 (7.7%) with EBRT+BT, and 3,131 (35.6%) with surgery. 7-year PCSM rates were 26.9%, 14.1%, and 13.7% for EBRT, EBRT+BT, and surgery respectively (p < 0.001)(figure 1). 7-year overall mortality rates were 41.6%, 26.3%, and 19.4% for EBRT, EBRT+BT, and surgery respectively (p < 0.001). When controlling for age, Gleason score, clinical T stage, and PSA level on multivariate analysis, EBRT had greater PCSM than either surgery or EBRT+BT (HR 0.36, 95% CI 0.25-0.51, p < 0.001 and HR 0.56, 95% CI 0.33-0.90, p = 0.015 respectively). Comparison of PCSM and overall mortality between surgery and EBRT+BT revealed HR 0.38 (95% CI 0.20-0.77, p = 0.01) and HR 0.49 (95% CI 0.33-0.76, p = 0.002) respectively. CONCLUSIONS: Among men with localized Gleason 9-10 disease, surgery and EBRT+BT showed significant improvement in survival outcomes compared to EBRT alone. When compared with EBRT+BT, surgery showed improvement in PCSM and overall mortality. Future prospective studies are warranted. Source of Funding: none Baltimore, MD© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e600-e600 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Amy Nemirovsky* More articles by this author Hubert Huang More articles by this author Michael Naslund More articles by this author M. Minhaj Siddiqui More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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- W2942223913 title "MP41-10 SURVIVAL OUTCOMES OF INITIAL LOCAL THERAPY ON CLINICALLY LOCALIZED GLEASON 9-10 PROSTATE CANCER: A SURVEILLANCE, EPIDEMIOLOGY, AND END RESULTS DATABASE ANALYSIS" @default.
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