Anatomical patterns of recurrence following biochemical relapse after post-prostatectomy salvage radiation therapy

A multi-institutional study

William C. Jackson, Neil B. Desai, Ahmed E. Abugharib, Vasu Tumati, Robert T. Dess, Jae Y. Lee, Shuang G. Zhao, Moaaz Soliman, Michael Folkert, Aaron Laine, Raquibul Hannan, Zachary S. Zumsteg, Howard Sandler, Daniel A. Hamstra, Jeffrey S. Montgomery, David C. Miller, Mike A. Kozminski, Brent K. Hollenbeck, Jason W. Hearn, Ganesh Palapattu & 5 others Scott A. Tomlins, Rohit Mehra, Todd M. Morgan, Felix Y. Feng, Daniel E. Spratt

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objectives: To characterise the frequency and detailed anatomical sites of failure for patients receiving post-radical prostatectomy (RP) salvage radiation therapy (SRT). Patients and Methods: A multi-institutional retrospective study was performed on 574 men who underwent SRT between 1986 and 2013. Anatomical recurrence patterns were classified as lymphotrophic (lymph nodes only), osteotrophic (bone only), or multifocal if both were present. Isolated first failure sites were defined as sites of initial clinically detected recurrence that remained isolated for at least 3 months. Results: The median follow-up after SRT was 6.8 years. The 8-year rates of local, regional, and distant failure for patients undergoing SRT were 2%, 6%, and 21%, respectively. Of the 22% men (128 of 574) who developed a clinically detectable recurrence, 17%, 50%, and 31% were lymphotrophic, osteotrophic, and multifocal, respectively. The trophic nature of metastases was prognostic for distant metastases-free survival (DMFS) and prostate cancer-specific survival (PCSS); the 10-year rates of DMFS were 18%, 5%, and 7% (P < 0.01), and PCSS were 78%, 68%, and 56% (P < 0.01), for lymphotrophic, osteotrophic, and multifocal failure patterns, respectively. Conclusions: We demonstrate that trophism for metastatic site has significant prognostic impact on PCSS in men treated with SRT. Radiographic local failure is an uncommon event after SRT when compared to historical data of patients treated with surgery monotherapy. However, distant failure remains a challenge in this patient population and warrants further therapeutic investigation.

Original languageEnglish (US)
JournalBJU International
DOIs
StateAccepted/In press - 2017

Fingerprint

Salvage Therapy
Prostatectomy
Radiotherapy
Recurrence
Survival
Prostatic Neoplasms
Neoplasm Metastasis
Retrospective Studies
Lymph Nodes
Bone and Bones
Population

Keywords

  • #PCSM
  • #ProstateCancer
  • Patterns of failure
  • Radical prostatectomy
  • Salvage radiotherapy

ASJC Scopus subject areas

  • Urology

Cite this

Anatomical patterns of recurrence following biochemical relapse after post-prostatectomy salvage radiation therapy : A multi-institutional study. / Jackson, William C.; Desai, Neil B.; Abugharib, Ahmed E.; Tumati, Vasu; Dess, Robert T.; Lee, Jae Y.; Zhao, Shuang G.; Soliman, Moaaz; Folkert, Michael; Laine, Aaron; Hannan, Raquibul; Zumsteg, Zachary S.; Sandler, Howard; Hamstra, Daniel A.; Montgomery, Jeffrey S.; Miller, David C.; Kozminski, Mike A.; Hollenbeck, Brent K.; Hearn, Jason W.; Palapattu, Ganesh; Tomlins, Scott A.; Mehra, Rohit; Morgan, Todd M.; Feng, Felix Y.; Spratt, Daniel E.

In: BJU International, 2017.

Research output: Contribution to journalArticle

Jackson, WC, Desai, NB, Abugharib, AE, Tumati, V, Dess, RT, Lee, JY, Zhao, SG, Soliman, M, Folkert, M, Laine, A, Hannan, R, Zumsteg, ZS, Sandler, H, Hamstra, DA, Montgomery, JS, Miller, DC, Kozminski, MA, Hollenbeck, BK, Hearn, JW, Palapattu, G, Tomlins, SA, Mehra, R, Morgan, TM, Feng, FY & Spratt, DE 2017, 'Anatomical patterns of recurrence following biochemical relapse after post-prostatectomy salvage radiation therapy: A multi-institutional study', BJU International. https://doi.org/10.1111/bju.13792
Jackson, William C. ; Desai, Neil B. ; Abugharib, Ahmed E. ; Tumati, Vasu ; Dess, Robert T. ; Lee, Jae Y. ; Zhao, Shuang G. ; Soliman, Moaaz ; Folkert, Michael ; Laine, Aaron ; Hannan, Raquibul ; Zumsteg, Zachary S. ; Sandler, Howard ; Hamstra, Daniel A. ; Montgomery, Jeffrey S. ; Miller, David C. ; Kozminski, Mike A. ; Hollenbeck, Brent K. ; Hearn, Jason W. ; Palapattu, Ganesh ; Tomlins, Scott A. ; Mehra, Rohit ; Morgan, Todd M. ; Feng, Felix Y. ; Spratt, Daniel E. / Anatomical patterns of recurrence following biochemical relapse after post-prostatectomy salvage radiation therapy : A multi-institutional study. In: BJU International. 2017.
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title = "Anatomical patterns of recurrence following biochemical relapse after post-prostatectomy salvage radiation therapy: A multi-institutional study",
abstract = "Objectives: To characterise the frequency and detailed anatomical sites of failure for patients receiving post-radical prostatectomy (RP) salvage radiation therapy (SRT). Patients and Methods: A multi-institutional retrospective study was performed on 574 men who underwent SRT between 1986 and 2013. Anatomical recurrence patterns were classified as lymphotrophic (lymph nodes only), osteotrophic (bone only), or multifocal if both were present. Isolated first failure sites were defined as sites of initial clinically detected recurrence that remained isolated for at least 3 months. Results: The median follow-up after SRT was 6.8 years. The 8-year rates of local, regional, and distant failure for patients undergoing SRT were 2{\%}, 6{\%}, and 21{\%}, respectively. Of the 22{\%} men (128 of 574) who developed a clinically detectable recurrence, 17{\%}, 50{\%}, and 31{\%} were lymphotrophic, osteotrophic, and multifocal, respectively. The trophic nature of metastases was prognostic for distant metastases-free survival (DMFS) and prostate cancer-specific survival (PCSS); the 10-year rates of DMFS were 18{\%}, 5{\%}, and 7{\%} (P < 0.01), and PCSS were 78{\%}, 68{\%}, and 56{\%} (P < 0.01), for lymphotrophic, osteotrophic, and multifocal failure patterns, respectively. Conclusions: We demonstrate that trophism for metastatic site has significant prognostic impact on PCSS in men treated with SRT. Radiographic local failure is an uncommon event after SRT when compared to historical data of patients treated with surgery monotherapy. However, distant failure remains a challenge in this patient population and warrants further therapeutic investigation.",
keywords = "#PCSM, #ProstateCancer, Patterns of failure, Radical prostatectomy, Salvage radiotherapy",
author = "Jackson, {William C.} and Desai, {Neil B.} and Abugharib, {Ahmed E.} and Vasu Tumati and Dess, {Robert T.} and Lee, {Jae Y.} and Zhao, {Shuang G.} and Moaaz Soliman and Michael Folkert and Aaron Laine and Raquibul Hannan and Zumsteg, {Zachary S.} and Howard Sandler and Hamstra, {Daniel A.} and Montgomery, {Jeffrey S.} and Miller, {David C.} and Kozminski, {Mike A.} and Hollenbeck, {Brent K.} and Hearn, {Jason W.} and Ganesh Palapattu and Tomlins, {Scott A.} and Rohit Mehra and Morgan, {Todd M.} and Feng, {Felix Y.} and Spratt, {Daniel E.}",
year = "2017",
doi = "10.1111/bju.13792",
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TY - JOUR

T1 - Anatomical patterns of recurrence following biochemical relapse after post-prostatectomy salvage radiation therapy

T2 - A multi-institutional study

AU - Jackson, William C.

AU - Desai, Neil B.

AU - Abugharib, Ahmed E.

AU - Tumati, Vasu

AU - Dess, Robert T.

AU - Lee, Jae Y.

AU - Zhao, Shuang G.

AU - Soliman, Moaaz

AU - Folkert, Michael

AU - Laine, Aaron

AU - Hannan, Raquibul

AU - Zumsteg, Zachary S.

AU - Sandler, Howard

AU - Hamstra, Daniel A.

AU - Montgomery, Jeffrey S.

AU - Miller, David C.

AU - Kozminski, Mike A.

AU - Hollenbeck, Brent K.

AU - Hearn, Jason W.

AU - Palapattu, Ganesh

AU - Tomlins, Scott A.

AU - Mehra, Rohit

AU - Morgan, Todd M.

AU - Feng, Felix Y.

AU - Spratt, Daniel E.

PY - 2017

Y1 - 2017

N2 - Objectives: To characterise the frequency and detailed anatomical sites of failure for patients receiving post-radical prostatectomy (RP) salvage radiation therapy (SRT). Patients and Methods: A multi-institutional retrospective study was performed on 574 men who underwent SRT between 1986 and 2013. Anatomical recurrence patterns were classified as lymphotrophic (lymph nodes only), osteotrophic (bone only), or multifocal if both were present. Isolated first failure sites were defined as sites of initial clinically detected recurrence that remained isolated for at least 3 months. Results: The median follow-up after SRT was 6.8 years. The 8-year rates of local, regional, and distant failure for patients undergoing SRT were 2%, 6%, and 21%, respectively. Of the 22% men (128 of 574) who developed a clinically detectable recurrence, 17%, 50%, and 31% were lymphotrophic, osteotrophic, and multifocal, respectively. The trophic nature of metastases was prognostic for distant metastases-free survival (DMFS) and prostate cancer-specific survival (PCSS); the 10-year rates of DMFS were 18%, 5%, and 7% (P < 0.01), and PCSS were 78%, 68%, and 56% (P < 0.01), for lymphotrophic, osteotrophic, and multifocal failure patterns, respectively. Conclusions: We demonstrate that trophism for metastatic site has significant prognostic impact on PCSS in men treated with SRT. Radiographic local failure is an uncommon event after SRT when compared to historical data of patients treated with surgery monotherapy. However, distant failure remains a challenge in this patient population and warrants further therapeutic investigation.

AB - Objectives: To characterise the frequency and detailed anatomical sites of failure for patients receiving post-radical prostatectomy (RP) salvage radiation therapy (SRT). Patients and Methods: A multi-institutional retrospective study was performed on 574 men who underwent SRT between 1986 and 2013. Anatomical recurrence patterns were classified as lymphotrophic (lymph nodes only), osteotrophic (bone only), or multifocal if both were present. Isolated first failure sites were defined as sites of initial clinically detected recurrence that remained isolated for at least 3 months. Results: The median follow-up after SRT was 6.8 years. The 8-year rates of local, regional, and distant failure for patients undergoing SRT were 2%, 6%, and 21%, respectively. Of the 22% men (128 of 574) who developed a clinically detectable recurrence, 17%, 50%, and 31% were lymphotrophic, osteotrophic, and multifocal, respectively. The trophic nature of metastases was prognostic for distant metastases-free survival (DMFS) and prostate cancer-specific survival (PCSS); the 10-year rates of DMFS were 18%, 5%, and 7% (P < 0.01), and PCSS were 78%, 68%, and 56% (P < 0.01), for lymphotrophic, osteotrophic, and multifocal failure patterns, respectively. Conclusions: We demonstrate that trophism for metastatic site has significant prognostic impact on PCSS in men treated with SRT. Radiographic local failure is an uncommon event after SRT when compared to historical data of patients treated with surgery monotherapy. However, distant failure remains a challenge in this patient population and warrants further therapeutic investigation.

KW - #PCSM

KW - #ProstateCancer

KW - Patterns of failure

KW - Radical prostatectomy

KW - Salvage radiotherapy

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U2 - 10.1111/bju.13792

DO - 10.1111/bju.13792

M3 - Article

JO - BJU International

JF - BJU International

SN - 1464-4096

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