To update a previously proposed prognostic scoring system that predicts risk of biochemical recurrence (BCR) after salvage radiation therapy (SRT) for recurrent prostate cancer when using additional patients and a PSA value of 0.2 ng/ml and rising as the definition of BCR.
We included 577 patients who received SRT for a rising PSA following radical prostatectomy in this retrospective cohort study. Clinical, pathological, and SRT characteristics were evaluated for association with BCR using relative risks (RRs) from multivariable Cox regression models.
With a median follow-up of 5.5 years following SRT, 354 patients (61%) experienced BCR. At 5 years following SRT, 40% of patients were free of BCR. Independent associations with BCR were identified for pre-SRT PSA (RR [doubling]: 1.25, P<0.001), pathological tumor stage (RR [T3a vs. T2]: 1.21, P=0.19; RR [T3b/T4 vs. T2]: 2.09, P<0.001; overall P<0.001), Gleason score (RR [7 vs. <7]: 1.63, P<0.001; RR [8-10 vs. <7]: 2.28, P<0.001; overall P<0.001), and surgical margin status (RR [positive vs. negative]: 0.71, P=0.003).We combined these 4 variables to create a prognostic scoring system that predicted BCR risk with a c-index of 0.66. Scores ranged from 0 to 7, and 5-year freedom from BCR for different levels of the score was as follows: Score=0-1: 66%, Score=2: 46%, Score=3: 28%, Score=4: 19%, and Score=5-7: 15%.
We developed a scoring system that provides an estimation of biochemical outcome after SRT. These findings will be useful for patients and physicians in decision making for radiation therapy in the salvage setting. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.