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Local Failure Events in Prostate Cancer Treated with Radiotherapy:A Pooled Analysis of 18 Randomized Trials from the Meta-analysis of Randomized Trials in Cancer of the Prostate Consortium (LEVIATHAN)
- Source :
- Meta-Analysis of Randomized Trials in Cancer of the Prostate (MARCAP) Consortium Investigators , Ma , T M , Chu , F I , Sandler , H , Feng , F Y , Efstathiou , J A , Jones , C U , Roach , M , Rosenthal , S A , Pisansky , T , Michalski , J M , Bolla , M , de Reijke , T M , Maingon , P , Neven , A , Denham , J , Steigler , A , Joseph , D , Nabid , A , Souhami , L , Carrier , N , Incrocci , L , Heemsbergen , W , Pos , F J , Sydes , M R , Dearnaley , D P , Tree , A C , Syndikus , I , Hall , E , Cruickshank , C , Malone , S , Roy , S , Sun , Y , Zaorsky , N G , Nickols , N G , Reiter , R E , Rettig , M B , Steinberg , M L , Reddy , V K , Xiang , M , Romero , T , Spratt , D E & Kishan , A U 2022 , ' Local Failure Events in Prostate Cancer Treated with Radiotherapy : A Pooled Analysis of 18 Randomized Trials from the Meta-analysis of Randomized Trials in Cancer of the Prostate Consortium (LEVIATHAN) ' , European Urology , vol. 82 , no. 5 , pp. 487-498 .
- Publication Year :
- 2022
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Abstract
- Context: The prognostic importance of local failure after definitive radiotherapy (RT) in National Comprehensive Cancer Network intermediate- and high-risk prostate cancer (PCa) patients remains unclear. Objective: To evaluate the prognostic impact of local failure and the kinetics of distant metastasis following RT. Evidence acquisition: A pooled analysis was performed on individual patient data of 12 533 PCa (6288 high-risk and 6245 intermediate-risk) patients enrolled in 18 randomized trials (conducted between 1985 and 2015) within the Meta-analysis of Randomized Trials in Cancer of the Prostate Consortium. Multivariable Cox proportional hazard (PH) models were developed to evaluate the relationship between overall survival (OS), PCa-specific survival (PCSS), distant metastasis-free survival (DMFS), and local failure as a time-dependent covariate. Markov PH models were developed to evaluate the impact of specific transition states. Evidence synthesis: The median follow-up was 11 yr. There were 795 (13%) local failure events and 1288 (21%) distant metastases for high-risk patients and 449 (7.2%) and 451 (7.2%) for intermediate-risk patients, respectively. For both groups, 81% of distant metastases developed from a clinically relapse-free state (cRF state). Local failure was significantly associated with OS (hazard ratio [HR] 1.17, 95% confidence interval [CI] 1.06–1.30), PCSS (HR 2.02, 95% CI 1.75–2.33), and DMFS (HR 1.94, 95% CI 1.75–2.15, p < 0.01 for all) in high-risk patients. Local failure was also significantly associated with DMFS (HR 1.57, 95% CI 1.36–1.81) but not with OS in intermediate-risk patients. Patients without local failure had a significantly lower HR of transitioning to a PCa-specific death state than those who had local failure (HR 0.32, 95% CI 0.21–0.50, p < 0.001). At later time points, more distant metastases emerged after a local failure event for both groups. Conclusions: Local failure is an independent prognosticator of OS, PCSS
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- Database :
- OAIster
- Journal :
- Meta-Analysis of Randomized Trials in Cancer of the Prostate (MARCAP) Consortium Investigators , Ma , T M , Chu , F I , Sandler , H , Feng , F Y , Efstathiou , J A , Jones , C U , Roach , M , Rosenthal , S A , Pisansky , T , Michalski , J M , Bolla , M , de Reijke , T M , Maingon , P , Neven , A , Denham , J , Steigler , A , Joseph , D , Nabid , A , Souhami , L , Carrier , N , Incrocci , L , Heemsbergen , W , Pos , F J , Sydes , M R , Dearnaley , D P , Tree , A C , Syndikus , I , Hall , E , Cruickshank , C , Malone , S , Roy , S , Sun , Y , Zaorsky , N G , Nickols , N G , Reiter , R E , Rettig , M B , Steinberg , M L , Reddy , V K , Xiang , M , Romero , T , Spratt , D E & Kishan , A U 2022 , ' Local Failure Events in Prostate Cancer Treated with Radiotherapy : A Pooled Analysis of 18 Randomized Trials from the Meta-analysis of Randomized Trials in Cancer of the Prostate Consortium (LEVIATHAN) ' , European Urology , vol. 82 , no. 5 , pp. 487-498 .
- Notes :
- application/pdf, English
- Publication Type :
- Electronic Resource
- Accession number :
- edsoai.on1352447588
- Document Type :
- Electronic Resource