However, when we re-analyzed data with 8 years of follow-up and added a few more patients and looked more thoroughly, we found that we really couldnt find any pretreatment factors that, under multivariate analysis, would indicate a predictor for distant metastasis, Dr. On first analysis of the information, it appeared that stage, Gleason score, and pretreatment PSA were going to be of importance. ∺nd this is from the point of the rise in PSA, not from the time of treatment, he said. At 5 years, 50% had failed locally, and at 8 years, 59% had failed locally.įreedom from distant metastasis was 87% at 5 years, and 69% at 8 years. Local control was a main issue for the test patients, Dr. Treatment for the rising PSA was at the discretion of the investigating physician: 91 patients received no additional treatment 216 patients were given androgen ablation (181 for a rising PSA and 35 who were diagnosed with distant metastasis at the time of the onset of the rise in PSA) 42 patients underwent cryosurgery and 8 patients underwent prostatectomy. Follow-up after the onset of the rise of PSA ranged from 3 to 132 months (median, 53 months). The time to onset of the rise in PSA was from 1 to 100 months (median, 20 months). Of this parent population, there were 357 patients who developed a rising PSA level (the test cohort).

Follow-up ranged from 12 to 146 months (median, 59 months). None of the patients had received androgen ablation at the time of initial therapy. The external beam radiation dose varied from 60 to 78 Gy (median, 68 Gy). All patients had T1 to T3 disease, and their pretreatment PSA levels ranged from 0.3 to 150 ng/mL (median, 8.4 ng/mL).

The parent population consisted of 1,119 patients, all treated between 19. Their overall survival was the same as predicted survival, and I think that is a key significant point, he said. He added that even those who developed a rising PSA still had fairly good outcomes. Patients in the cohort represented an average spectrum of patients who received radiation therapy during the 1980s and 1990s for prostate cancer, Dr. Smith, assistant professor of radiation oncology, M.D.

Of note, no patient developed distant metastasis without a rising PSA level, said Dr. Smith III, MD, reported at the 41st Annual Scientific Meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO).

However, two post-treatment factors, PSA doubling time and time to onset of a rising PSA, were found to be major determinants of metastatic relapse, Lewis G. SAN ANTONIOIn a retrospective study of prostate cancer patients with a rising PSA after external beam radiation therapy, pretreatment factors appeared to have little independent influence on the development of metastatic disease.

Psa doubling time survival rate