Delayed therapy with curative intent in a contemporary prostate cancer watchful-waiting cohort

M. El-Geneidy, M. Garzotto, I. Panagiotou, Y. C. Hsieh, M. Mori, L. Peters, T. Klein, T. M. Beer

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

OBJECTIVE: To identify predictors of delayed therapy with curative intent, an increasingly common option in contemporary patients with prostate cancer who initially choose watchful waiting. PATIENTS AND METHODS: The characteristics of all patients at one institution and diagnosed with T1-4NXMO prostate cancer between 1993 and 2000 were prospectively recorded. Factors recorded included: age, tumour stage, histological type, Gleason score, serum prostate specific antigen (PSA) level, prostate volume, PSA density (PSAD), percentage of positive biopsy cores, and the initial treatment selection. Outcomes, including all cancer-directed interventions, all serum PSA values, and initial outcomes of all interventions with curative intent, were determined by review of all medical records and cancer registry data. RESULTS: Of 187 patients on watchful waiting, 175 had stage T1 or T2 cancer and were analysed primarily. Thirty-eight (22%) of these patients received delayed intervention with curative intent (15 radical prostatectomy, 17 external beam radiotherapy, six brachytherapy). Age (P <0.001) and percentage of positive biopsy cores (P = 0.042) were significant independent predictors of intervention with curative intent. When the PSA doubling time was added to the model it became a significant predictor (P = 0.018), with percentage positive biopsy cores (P = 0.022) and age (P <0.001). CONCLUSIONS: Therapy with curative intent is common in contemporary patients with prostate cancer who initially choose watchful waiting. Age and percentage positive biopsy cores are independent predictors of such intervention, with PSA doubling time also an independent predictor.

Original languageEnglish (US)
Pages (from-to)510-515
Number of pages6
JournalBJU International
Volume93
Issue number4
DOIs
StatePublished - Mar 2004

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Watchful Waiting
Prostate-Specific Antigen
Prostatic Neoplasms
Biopsy
Neoplasms
Therapeutics
Neoplasm Grading
Brachytherapy
Prostatectomy
Serum
Medical Records
Registries
Prostate
Radiotherapy

Keywords

  • Prostate cancer
  • Prostatectomy
  • Radiation treatment
  • Watchful waiting

ASJC Scopus subject areas

  • Urology

Cite this

Delayed therapy with curative intent in a contemporary prostate cancer watchful-waiting cohort. / El-Geneidy, M.; Garzotto, M.; Panagiotou, I.; Hsieh, Y. C.; Mori, M.; Peters, L.; Klein, T.; Beer, T. M.

In: BJU International, Vol. 93, No. 4, 03.2004, p. 510-515.

Research output: Contribution to journalArticle

El-Geneidy, M. ; Garzotto, M. ; Panagiotou, I. ; Hsieh, Y. C. ; Mori, M. ; Peters, L. ; Klein, T. ; Beer, T. M. / Delayed therapy with curative intent in a contemporary prostate cancer watchful-waiting cohort. In: BJU International. 2004 ; Vol. 93, No. 4. pp. 510-515.
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AB - OBJECTIVE: To identify predictors of delayed therapy with curative intent, an increasingly common option in contemporary patients with prostate cancer who initially choose watchful waiting. PATIENTS AND METHODS: The characteristics of all patients at one institution and diagnosed with T1-4NXMO prostate cancer between 1993 and 2000 were prospectively recorded. Factors recorded included: age, tumour stage, histological type, Gleason score, serum prostate specific antigen (PSA) level, prostate volume, PSA density (PSAD), percentage of positive biopsy cores, and the initial treatment selection. Outcomes, including all cancer-directed interventions, all serum PSA values, and initial outcomes of all interventions with curative intent, were determined by review of all medical records and cancer registry data. RESULTS: Of 187 patients on watchful waiting, 175 had stage T1 or T2 cancer and were analysed primarily. Thirty-eight (22%) of these patients received delayed intervention with curative intent (15 radical prostatectomy, 17 external beam radiotherapy, six brachytherapy). Age (P <0.001) and percentage of positive biopsy cores (P = 0.042) were significant independent predictors of intervention with curative intent. When the PSA doubling time was added to the model it became a significant predictor (P = 0.018), with percentage positive biopsy cores (P = 0.022) and age (P <0.001). CONCLUSIONS: Therapy with curative intent is common in contemporary patients with prostate cancer who initially choose watchful waiting. Age and percentage positive biopsy cores are independent predictors of such intervention, with PSA doubling time also an independent predictor.

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