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Titolo:
Perineural invasion is not predictive of biochemical outcome following prostate brachytherapy
Autore:
Merrick, GS; Butler, WM; Galbreath, RW; Lief, JH; Adamovich, E;
Indirizzi:
Schiffler Canc Ctr, Wheeling, WV USA Schiffler Canc Ctr Wheeling WV USASchiffler Canc Ctr, Wheeling, WV USA George Washington Univ, Med Ctr, Washington, DC 20037 USA George Washington Univ Washington DC USA 20037 , Washington, DC 20037 USA Wheeling Jesuit Univ, Wheeling, WV USA Wheeling Jesuit Univ Wheeling WV USA eling Jesuit Univ, Wheeling, WV USA Wheeling Hosp, Schiffler Canc Ctr, Dept Pathol, Wheeling, WV 26003 USA Wheeling Hosp Wheeling WV USA 26003 , Dept Pathol, Wheeling, WV 26003 USA
Titolo Testata:
CANCER JOURNAL
fascicolo: 5, volume: 7, anno: 2001,
pagine: 404 - 412
SICI:
1528-9117(200109/10)7:5<404:PIINPO>2.0.ZU;2-3
Fonte:
ISI
Lingua:
ENG
Soggetto:
NEEDLE-BIOPSY; EXTRAPROSTATIC EXTENSION; RADICAL PROSTATECTOMY; RADIATION-THERAPY; CARCINOMA; CANCER; ADENOCARCINOMA; IMPLANTATION; FAILURE; TUMOR;
Keywords:
prostate cancer; brachytherapy; perineural invasion; biochemical outcome;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
35
Recensione:
Indirizzi per estratti:
Indirizzo: Merrick, GS Wheeling Hosp, Schiffler Canc Ctr, Dept Pathol, 1 Med Pk, Wheeling, WV 26003 USA Wheeling Hosp 1 Med Pk Wheeling WV USA 26003 ing, WV 26003 USA
Citazione:
G.S. Merrick et al., "Perineural invasion is not predictive of biochemical outcome following prostate brachytherapy", CANCER J, 7(5), 2001, pp. 404-412

Abstract

PURPOSEThe purpose of this article is to evaluate whether the presence of perineural invasion (PNI) in the biopsy specimen is predictive of 5-year biochemical disease-free outcome after prostate brachy-therapy. MATERIALS AND METHODSFour hundred twenty-five patients underwent transperineal ultrasound-guided prostate brachytherapy using either Pd-103 or I-125 for clinical T1b/T3a NXMO (1997 American Joint Committee on Cancer) adenocarcinoma of the prostate gland from April 1995 to October 1999. No patient was lost to follow-up,and no patient underwent pathological lymph node staging. Two hundred twenty-one patients were implanted with 103Pd, and 204 patients were implanted with I-125. Of this cohort, 190 patients were implanted without supplemental beam radiation, and 235 received moderate-dose external-beam radiation therapy followed by a prostate brachytherapy boost. One hundred sixty-three patients received hormonal manipulation in conjunction with the brachytherapy implant (86 of these patients received moderate-dose external-beam radiation therapy before brachytherapy), and 262 patients were hormone naive. Perineural invasion, defined as carcinoma tracking along or around a nerve within the perineural space, was identified in 105 patients (24.7% of the population). The median patient age was 68 years (range, 48-81 years). The meanfollow-up was 37.1 +/- 15.2 months, and the median followup was 35.4 months (range, 6-74 months). Follow-up was calculated from the date of implantation. Biochemical disease-freesurvival was defined by the American Society of Therapeutic Radiation and Oncology (ASTRO) consensus definition. RESULTSWhen Kaplan-Meier survival analysis was performed, the presence of PNI didnot predict failure. When PN1 was entered into a Cox regression analysis with evaluated clinical predictors of failure (age, clinical T stage, pretreatment prostate-specific antigen level, and Gleason score) or treatment parameters (use of neoadjuvant hormonal therapy, supplemental external-beam radiation therapy, and choice of isotope), PNI did not add to the predictive strength of these variables. The median disease-free prostate-specific antigen level was 0.1 ng/mL for the entire cohort. CONCLUSIONSOur results indicate that actuarial 5-year biochemical outcomes with a prostate brachytherapy approach that utilizes generous periprostatic margins is not dependent on the presence of PNI. ln addition, PNI should not be usedas an independent prognosticator in determining the need for combined-modality therapy in patients undergoing prostate brachytherapy.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 23/01/20 alle ore 18:16:01