Prostate-specific antigen levels of ≤4 and >4 ng/mL and risk of prostate cancer-specific mortality in men with biopsy Gleason score 9 to 10 prostate cancer.

Cancer
Daniel W KimAnthony V D'Amico

Abstract

Defining workup beyond usual clinical practice that may improve treatment outcomes in men with a prostate-specific antigen (PSA) level of ≤4 ng/mL (vs >4 ng/mL) and Gleason score (GS) 9 to 10 prostate cancer (PC) remains to be determined. Between February 25, 1992, and February 25, 2016, 17,632 men with clinical T1-4 PC with a biopsy GS of 6 to 10 underwent radical prostatectomy at a single academic center. Multivariable Fine and Gray regressions were used to evaluate the risk of prostate cancer-specific mortality (PCSM) with an interaction model evaluating the prognostic significance of PSA ≤ 4 ng/mL versus PSA > 4 ng/mL among men with PC with a biopsy GS of 9 to 10 versus ≤8, with adjustments made for the time-dependent use of adjuvant and/or salvage radiation therapy and androgen deprivation therapy (ADT) in addition to known PC prognostic factors. There was a significant interaction in men with a biopsy GS of 9 to 10 versus ≤8 and a PSA level of ≤4 ng/mL versus >4 ng/mL (adjusted hazard ratio [AHR], 2.87; 95% confidence interval [CI], 1.02-8.08; P = .046). Specifically, among men with a biopsy GS of 9 to 10 and a PSA level of ≤4 ng/mL versus >4 ng/mL, there was a significantly higher rate of PCSM (AHR, 2.59; 95% CI, 1.19-5....Continue Reading

References

May 27, 2004·JAMA : the Journal of the American Medical Association·Jay F PiccirilloEdward L Spitznagel
Jul 28, 2005·JAMA : the Journal of the American Medical Association·Anthony V D'AmicoMing-Hui Chen
Jan 24, 2008·JAMA : the Journal of the American Medical Association·Anthony V D'AmicoPhilip W Kantoff
Feb 22, 2008·CA: a Cancer Journal for Clinicians·Ahmedin JemalMichael J Thun
Feb 4, 2009·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Ilir AgalliuRobert D Burk
Oct 25, 2011·BJU International·Barry B McGuireWilliam J Catalona
May 9, 2014·Journal of the National Comprehensive Cancer Network : JNCCN·Rahul AggarwalAndrew J Armstrong
Oct 29, 2015·The New England Journal of Medicine·Joaquin MateoJohann S de Bono

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