Disease-specific survival following the brachytherapy management of prostate cancer.
OBJECTIVE
To determine disease-specific survival (DSS) and associated predictive factors after prostate brachytherapy.


METHODS
A total of 1561 patients underwent brachytherapy for prostate cancer from 1990 to 2004 (median follow-up, 3.8 years). Treatment included brachytherapy alone (n = 634), brachytherapy and hormonal therapy (n = 420), and implant and external beam therapy (n = 507).


RESULTS
The DSS and overall survival rates at 10 years were 96% and 74%, respectively. Gleason score significantly impacted DSS, with 10-year rates of 98%, 91%, and 92% for scores of < or = 6, 7, and > or = 8, respectively (p < 0.0001). Multivariate analysis revealed that PSA status after treatment had the most significant effect on DSS. Ten-year DSS rates were 100%, 52%, and 98%, respectively for patients without PSA failure (n = 1430), failure with a doubling time (DT) < or = 10 months (n = 64), and failure with a DT > 10 months (n = 67), respectively (p < 0.0001). In patients with PSA failure, DSS rates were 30%, 67%, and 98%, for those with DT < or = 6 months, > 6-10 months, and > 10 months, respectively (p < 0.0001).


CONCLUSIONS
The 10-year DSS rate supports the efficacy of brachytherapy. Patients dying with disease within 10 years after treatment harbor inherently aggressive cancer with high Gleason scores and short DT.
Stock
Richard G
RG
Department of Radiation Oncology, Mount Sinai Hospital, New York, NY 10029, USA. richard.stock@msnyuhealth.org
Cesaretti
Jamie A
JA
Stone
Nelson N
NN
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001918:Brachytherapy; D018572:Disease-Free Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000401:mortality* / Q000532:radiotherapy*
D017430:Prostate-Specific Antigen