Pd29-12 the Impact of the Time Elapsed Between Primary Treatment and BCR on Cancer Specific Mortality in Patients Who Experienced BCR After Primary Treatment

You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History I (PD29)1 May 2024PD29-12 THE IMPACT OF THE TIME ELAPSED BETWEEN PRIMARY TREATMENT AND BCR ON CANCER SPECIFIC MORTALITY IN PATIENTS WHO EXPERIENCED BCR AFTER PRIMARY TREATMENT Francesco Pellegrino, Ugo G. Falagario, Ahmad Abbadi, Lars Björnebo, Alexander Valdman, Giuseppe Carrieri, Alberto Briganti, Francesco Montorsi, Olof Akre, Markus Aly, Martin Eklund, Tobias Nordström, Henrik Grönberg, Anna Lantz, and Peter Wiklund Francesco PellegrinoFrancesco Pellegrino , Ugo G. FalagarioUgo G. Falagario , Ahmad AbbadiAhmad Abbadi , Lars BjörneboLars Björnebo , Alexander ValdmanAlexander Valdman , Giuseppe CarrieriGiuseppe Carrieri , Alberto BrigantiAlberto Briganti , Francesco MontorsiFrancesco Montorsi , Olof AkreOlof Akre , Markus AlyMarkus Aly , Martin EklundMartin Eklund , Tobias NordströmTobias Nordström , Henrik GrönbergHenrik Grönberg , Anna LantzAnna Lantz , and Peter WiklundPeter Wiklund View All Author Informationhttps://doi.org/10.1097/01.JU.0001008736.23117.7f.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Biochemical recurrence (BCR) is common after prostate cancer (PCa) treatment. Since the risk of mortality for patients with BCR is not invariably high, it is crucial to identify those at high risk of death to adopt an adequate treatment. One feature that has not been adequately studied for this purpose is the time elapsed between primary treatment and BCR. We aimed to assess if the time to BCR is associated with cancer specific mortality (CSM) in patients who experienced BCR after prostatectomy (RP) or radiotherapy (RT). METHODS: This is a population-based study including all men in Stockholm County who underwent RP or RT with curative intent and PSA follow-up from 2003 to 2019. We included only patients who had BCR after treatment (PSA≥0.2 after RP, and a PSA≥2 + nadir after RT). We tested the association between time to BCR and CSM using Cox model adjusted for CAPRA risk group, PSA at recurrence, hormonal therapy before BCR, and year of treatment. The analyses were performed for the whole population and for patients stratified by primary treatment. RESULTS: We included 3606 patients with BCR. Among RP (n=2392) vs RT patients (n=1214), 547 (23%) vs 98 (8.1%), 1205 (52%) vs 469 (39%), and 610 (26%) vs 469 (39%) fell in the low, intermediate, and high CAPRA risk group, respectively. Median time to BCR was 29 (IQR 11-58) and 33 mths (IQR 16-60) after RP and RT, respectively. At a median follow-up for survivors of 52 mths after BCR, 394 patients died for PCa. Time to BCR was associated with a lower risk of CSM in the whole population (hazard ratio [HR] 0.98, 95% Confidence interval [CI] 0.97–0.98, per mth), in RP (HR 0.99, CI 0.98–1.00), and RT patients (HR 0.97, CI 0.96–0.98). Figure 1 shows adjusted survival probability for patients grouped according to primary treatment and CAPRA risk group; we can see that this strongly varied according to time to BCR. For instance, patients with intermediate-risk cancer who experienced BCR >3yr after RP had a cancer specific survival probability at 10yr after BCR>95%. CONCLUSIONS: Time to BCR is significantly associated with CSM. This information should be considered to stratify patients with BCR. Oncological follow-up after primary treatment could be safely discontinued after a long follow-up for low and intermediated risk patients given their low risk of CSM. Download PPT Source of Funding: No © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e623 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Francesco Pellegrino More articles by this author Ugo G. Falagario More articles by this author Ahmad Abbadi More articles by this author Lars Björnebo More articles by this author Alexander Valdman More articles by this author Giuseppe Carrieri More articles by this author Alberto Briganti More articles by this author Francesco Montorsi More articles by this author Olof Akre More articles by this author Markus Aly More articles by this author Martin Eklund More articles by this author Tobias Nordström More articles by this author Henrik Grönberg More articles by this author Anna Lantz More articles by this author Peter Wiklund More articles by this author Expand All Advertisement PDF downloadLoading ...