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Gewählte Publikation:

Mayer, R; Pummer, K; Quehenberger, F; Mayer, E; Feigl, G; Langsenlehner, U; Hackl, A.
Analysis of competing risk parameters in irradiated prostate cancer patients.
Strahlenther Onkol. 2003; 179(7):452-457
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Autor/innen der Med Uni Graz:
Feigl Georg
Hackl Arnulf
Langsenlehner Uwe
Mayer Elisabeth
Mayer Ramona
Pummer Karl
Quehenberger Franz
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Abstract:
PURPOSE: Retrospective competing risk analysis of prognostic factors in definitive-irradiated prostate cancer patients. PATIENTS AND METHODS: Data of 652 patients were analyzed according to three age subgroups (< 65, 65 < or = 75, > 75 years; Table 1). Pre-RT PSA values (median 13.4 ng/ml) were available for 340 patients. Adjuvant hormone therapy (n = 261) consisted either of orchiectomy (n = 151) or LHRH agonist with/without antiandrogen therapy or, in the early years, diethylstilbestrol. Neoadjuvant hormone therapy (n = 31) using LHRH agonists was given 6 months before and during radiotherapy. RESULTS: Biochemical failure was observed in 69/340 patients, 5 years after biochemical failure, 64.9% of them also had failed clinically. The cumulative incidence of local failure (LF) and distant metastases (DM) was 9.4% and 37.2%, respectively; LF and DM at the same time were seen in 18.2%. On multivariate analysis (Tables 2 and 3), advanced stage (relative risk [RR] 4.54), pre-RT PSA > 20 ng/ml (RR 2.79) and poorly differentiated tumors (RR 2.96) were significant predictors of biochemical failure. Advanced stage increased the risk of LF (RR 2.18), DM (RR 3.66), and prostate cancer death (PCD; RR 4.30). Hormone therapy decreased the risk of biochemical failure (RR 0.67), DM (RR 0.59), and PCD (RR 0.60) without reaching statistical significance. Median follow-up was 7.6 years. CONCLUSION: Risk of biochemical failure was predicted by pre-RT PSA, stage, and grade; in patients with biochemical failure, the cumulative incidence of death from intercurrent diseases and PCD was 25.0% and 29.2% after 5 years, respectively. The risk of DM and PCD was predicted by stage and grade. Higher age (> 75 years) decreased the relative risk of LF, DM, and PCD significantly.
Find related publications in this database (using NLM MeSH Indexing)
Aged -
Aged, 80 and over -
Antineoplastic Agents, Hormonal - therapeutic use
Chemotherapy, Adjuvant - therapeutic use
Combined Modality Therapy - therapeutic use
Follow-Up Studies - therapeutic use
Humans - therapeutic use
Male - therapeutic use
Middle Aged - therapeutic use
Neoadjuvant Therapy - therapeutic use
Orchiectomy - therapeutic use
Prostate-Specific Antigen - blood
Prostatic Neoplasms - blood
Risk - blood
Survival Analysis - blood
Tumor Markers, Biological - blood

Find related publications in this database (Keywords)
prostate cancer
external radiotherapy
competing risk analysis
biochemical failure
clinical failure
survival
prognostic factors
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