OncologyEffect of Percentage of Positive Prostate Biopsy Cores on Biochemical Outcome in Low-risk PCa Treated With Brachytherapy or 3D-CRT
Section snippets
Patient Selection
From 1993 to 2006, a total of 360 patients with low-risk prostate cancer (PSA ≤10 ng/mL, Gleason score ≤6, and clinical Stage T1c or T2a) evaluated at the Kimmel Cancer Center Genitourinary Multidisciplinary cancer clinic at Thomas Jefferson University were retrospectively identified. Of these 360 patients, 189 had undergone 3D-CRT and 171 had undergone brachytherapy. Patients undergoing androgen suppression therapy were excluded. Table 1 lists the pretreatment demographics of the patient
Results
The patient treatment demographics are listed in Table 1. Of the 360 patients included in this study, 189 had undergone 3D-CRT and 171 had undergone brachytherapy. The median age of the 3D-CRT group was 70 years (range 49-83), and the median age for the brachytherapy group was 65 years (range 42-78). Most patients in both groups had Stage cT1c disease (77% 3D-CRT and 80% brachytherapy). The median follow-up was 52 months (range 1-148) for the 3D-CRT group and was 36 months (range 1-114) for the
Comment
The pretreatment risk groups established by D'Amico et al.4 identified a correlation between clinical T stage, pretreatment PSA level, and biopsy Gleason score with freedom from PSA recurrence. Efforts have been made to determine other prognostic variables to aid in predicting the clinical and pathologic outcomes, as well as to provide optimal patient counseling regarding treatment modalities. The PPBCs has already been associated with tumor volume,15 adverse pathologic features such as
Conclusions
Low-risk prostate cancer has become the predominant presentation of disease in clinical practice today.2 In addition, there is an increasing trend for patients in this group to receive radiotherapy or brachytherapy as curative treatment.3 When considering the tumor volume, as measured by the PPBCs, we found no significant difference between patients receiving brachytherapy or 3D-CRT for the treatment of low-risk disease. On the basis of these findings, in patients with low-risk prostate cancer,
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