Prostate-specific antigen density as a predictor of recurrence-free survival following combined hormonal-radiation therapy of localized prostate cancer

A. Kneev, M. Shkolnik, O. Bogomolov, N. D. Verdiev, G. Zharinov
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Abstract

Background. Prostate cancer is amongst one of the most prevalent cancers in men worldwide. Combined hormonal-radiation therapy has become a standard of care for localized prostate cancer definitive treatment. As many as 30 % of men are at risk for disease progression within 10 years following radical treatment.Aim. To assess the significance of prostate-specific antigen (PSA) density as a predictor of recurrence-free survival following combined hormonal-radiation therapy in patients with localized prostate cancer.Materials and methods. We conducted a retrospective study of 272 patients with clinically localized prostate cancer treatment results who received combined hormonal-radiation therapy between January 1996 and December 2016.Results. On the basis of our study, we confirmed high prognostic value of PSA density among patients with localized prostate cancer who received combined hormonal-radiation treatment. We utilized ROC-analysis in order to determine the threshold value of the PSA density index – 0.376 ng/ml/cm3, exceeding of which was associated with statistically significant reduction in the recurrence-free survival rate. The area under the curve was 0.711 (95 % confidence interval 0.653–0.764; p <0.0001). The risk of recurrence increased with rising of PSA density.Conclusion. PSA density has proven to be a reliable tool for assessing the risk of prostate cancer recurrence among patients with localized prostate cancer who have undergone combined hormonal-radiation therapy.
前列腺特异性抗原密度作为局部前列腺癌激素-放射联合治疗后无复发生存的预测因子
背景。前列腺癌是世界上最常见的男性癌症之一。激素-放射联合治疗已成为局部前列腺癌决定性治疗的标准治疗方法。多达30%的男性在根治性治疗后的10年内有疾病进展的危险。评估前列腺特异性抗原(PSA)密度作为局限性前列腺癌患者激素-放射联合治疗后无复发生存的预测因子的意义。材料和方法。我们对1996年1月至2016年12月期间接受激素-放射联合治疗的272例临床局限性前列腺癌患者的治疗结果进行了回顾性研究。在我们的研究基础上,我们证实了PSA密度在接受激素-放射联合治疗的局限性前列腺癌患者中具有很高的预后价值。我们使用roc分析来确定PSA密度指数的阈值0.376 ng/ml/cm3,超过该阈值与无复发生存率显著降低相关。曲线下面积为0.711(95%置信区间0.653-0.764;p < 0.0001)。随着PSA浓度的升高,复发风险增加。PSA密度已被证明是评估接受激素-放射联合治疗的局限性前列腺癌患者前列腺癌复发风险的可靠工具。
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