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Panminerva Medica 2016 June;58(2):109-14


language: English

Percentage of positive prostate biopsies independently predicts biochemical outcome following radiation therapy for prostate cancer

Domenico GABRIELE 1, Monica GARIBALDI 1, Giuseppe GIRELLI 2, Stefano TARAGLIO 3, Eleonora DUREGON 4, Pietro GABRIELE 5, Caterina GUIOT 1, Enrico BOLLITO 4 , the EUREKA-2 CONSORTIUM

1 Neuroscience Department, Human Physiology Section University of Torino, Turin, Italy; 2 Division of Radiation Oncology, Civile Hospital, Ivrea, Italy; 3 Division of Pathology, San Giovanni Bosco Hospital, Turin, Italy; 4 Division of Pathology, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy; 5 Division of Radiation Oncology, FPO‑IRCCS Cancer Center of Candiolo, Turin, Italy


BACKGROUND: This work aims to definitely show the ability of percentage of positive biopsy cores (%PC) to independently predict biochemical outcome beyond traditional pretreatment risk-factors in prostate cancer (PCa) patients treated with radiotherapy.
METHODS: A cohort of 2493 men belonging to the EUREKA-2 retrospective multicentric database on (PCa) and treated with external-beam radiation therapy (EBRT) as primary treatment comprised the study population (median follow-up 50 months). A Cox regression time to prostate-specific antigen (PSA) failure analysis was performed to evaluate the predictive power of %PC, both in univariate and multivariate settings, with age, pretreatment PSA, clinical-radiological staging, bioptic Gleason Score (bGS), RT dose and RT +/- ADT as covariates.
RESULTS: P statistics for %PC is lower than 0.001 both in univariate and multivariate models. %PC as a continuous variable yields an AUC of 69% in ROC curve analysis for biochemical relapse. Four classes of %PC (1-20%, 21-50%, 51-80% and 81-100%) distinctly split patients for risk of biochemical relapse (overall log-rank test P<0.0001), with biochemical progression free survival (bPFS) at 5-years ranging from 88% to 58% and 10-years bPFS ranging from 80% to 38%.
CONCLUSIONS: We strongly affirm the usefulness of %PC information beyond main risk factors (PSA, staging and bGS) in predicting biochemical recurrence after EBRT for PCa. The stratification of patients according to %PC may be valuable to further discriminate cases with favourable or adverse prognosis.

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