For this study, the authors combined the Center for Prostate Disease Research and Johns Hopkins (CPDR/JHU) databases to investigate the association of the proximal PSA value on MFS in men with biochemical recurrence and PSADT <12 months. Among 31,296 men in the combined cohort, 513 men with BCR (>0.2ng/ml) with PSADT <12 months who received no adjuvant/salvage ADT/RT were prospectively followed until radiological evidence of M+. All patients were evaluated yearly with >1 PSA and scans at regular intervals until M+. The proximal PSA was defined as the most recent value >6 months prior to M+/censor. Among the 513 patients included in the analysis M+ occurred in 218 over a median follow-up of 9 years. The risk of M+ increased successively for PSADT 6.0-7.5, 4.5-6, 3.0-4.5, and <3.0 months, adjusted for pT stage and Gleason score. Proximal PSA ≥10ng/ml significantly increased risk of M+ in patients with PSADT <12 months, regardless of PSADT subgroup (HR 2.95, p<.0001). Median MFS was 4.0 years at proximal PSA >10ng/ml vs 20 years at proximal PSA <10ng/ml. The strength of this study is the long term follow-up with a large number of events and granular variable information, as well as utilizing two unique cohorts of patients.
The authors concluded that in men with PSADT<12 months, PSADT subgroups <7.5 months and proximal PSA >10ng/ml are independent predictors of MFS. Furthermore, a proximal PSA ≥10ng/ml further defines risk of M+ in biochemical recurrence of prostate cancer with PSADT<12 months. With additional validation, this information may provide utility in counselling patients.
Presented By: Mark C. Markowski, MD, PhD, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD, USA
Co-Authors: Daniel Suzman, Yongmei Chen, Bruce J. Trock, Jennifer Cullen, Zhaoyong Feng, Emmanuel S. Antonarakis, Channing Judith Paller, Misop Han, Alan W. Partin, Mario A. Eisenberger
Written By: Zachary Klaassen, MD, Urologic Oncology Fellow, University of Toronto, Princess Margaret Cancer Centre
at the 2017 ASCO Annual Meeting - June 2 - 6, 2017 - Chicago, Illinois, USA