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  • [In Vivo .] Predictors of Outcomes in Patients With Clinically Lymph Node Positive Prostate Cancer After Definitive Radiotherapy

    서울의대 / 김태현, 김재성*

  • 출처
    In Vivo .
  • 등재일
    2023 Sep-Oct
  • 저널이슈번호
    37(5):2365-2370.
  • 내용

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    Abstract
    Background/aim: Studies have suggested that benefits of definitive radiotherapy might be limited to specific patients in clinically lymph node positive (cN1) prostate cancer (PC). However, the beneficial subgroup remains to be elucidated. This study aimed to analyze survival outcomes and prognostic factors after definitive radiotherapy and androgen deprivation therapy (definitive RT+ADT) in these patients and to define subgroups of patients who would benefit from definitive RT+ADT the most.

    Patients and methods: A total of 60 patients with cN1 PC treated with definitive RT+ADT in a single tertiary hospital were accrued. Their clinicopathological variables were analyzed and a new subgroup was identified based on statistically significant variables.

    Results: At a median follow-up of 31 months, ADT duration ≥24 months (p=0.043, HR=0.26) and positive biopsy core ≥75% (p=0.044, HR=5.29) showed significant relationships with distant metastasis-free survival. Overall survival showed significant relationships with ADT duration ≥24 months (p=0.002, HR=0.06) and number of lymph node (LN) metastases ≥4 (p=0.019, HR=7.17). For prognostic subgroup analysis, patients were divided into three risk groups: low-risk group (LN metastases <4 and ADT ≥24 months), high-risk group (LN metastases ≥4 and ADT <24 months), and intermediate-risk group (all remaining cases). Three-year actuarial overall survival rates for the low-, intermediate-, and high-risk groups were 100%, 93.3%, and 45.7%.

    Conclusion: ADT duration and number of LN metastases were important prognostic factors in patients with cN1 PC receiving definitive RT+ADT, with low-risk cN1 PC patients showing better outcomes than others.

     

     

    Affiliations

    Tae Hyun Kim 1 2, Dong-Yun Kim 3, Jae-Sung Kim 4
    1Department of Radiation Oncology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.
    2Department of Human Systems Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
    3Department of Radiation Oncology, Chung-Ang University Hospital, Seoul, Republic of Korea.
    4Department of Radiation Oncology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea jskim@snubh.org.

  • 키워드
    Definitive radiotherapy; clinically lymph node positive prostate cancer; prognostic factors.
  • 편집위원

    임상적으로 임파절 전이(cN1)가 있는 전립선암 환자에서 남성호르몬박탈요법과 방사선치료(ADT+RT)의 예후 인자를 분석한 연구로, ADT 기간 및 임파절 전이 개수가 주요한 예후인자로 확인되었음을 보고했다. 특히 임파절 전이개수가 4개 미만이고 ADT 기간이 24개월 이상인 경우 저위험군으로 분류되어 더 좋은 예후(3년 actuarial overall survival rate 100%)를 보였다.

    2023-11-08 13:55:43

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