Author Interviews, Cancer, Prostate Cancer / 27.03.2014
Prostate Cancer: Likelihood of Death from Intermediate Risk Disease
MedicalResearch.com Interview with:
Florence K. Keane, MD
Harvard Radiation Oncology Program, Harvard Medical School
and Anthony V. D’Amico, MD, PhD
Department of Radiation Oncology,
Dana Farber Cancer Institute and Brigham and Women's Hospital, Boston, Massachusetts
MedicalResearch.com: What are the main findings of the study:
Answer: Patients with unfavorable intermediate-risk prostate cancer (PC) [1] have an increased risk of PC-specific mortality (PCSM) after radiotherapy (RT) with or without androgen suppression therapy (AST) compared to favorable intermediate-risk patients [2,3]. We provided validation for this prognostic subdivision using mature data with a median follow-up of 14.3 years from a prospective randomized trial comparing RT alone with RT and 6 months of AST [4]. We also assessed the risk of PCSM in patients with unfavorable intermediate-risk PC compared with high-risk prostate cancer.
Our main findings were as follows.
- First, there were no prostate cancer deaths observed in favorable intermediate-risk patients, despite 50% receiving RT alone.
- Second, there was not a statistically significant difference in the risk of PCSM in men with unfavorable intermediate-risk prostate cancer compared to men with high-risk PC after randomizing for age, comorbidities and treatment arm. While it is possible that a difference may emerge with longer follow-up, these results suggest that some men with unfavorable intermediate-risk PC may harbor occult GS 8-10 disease and could benefit from a 3.0-Tesla multiparametric MRI and targeted biopsy to rule out GS 8-10 disease.