Improved biochemical relapse-free survival for patients with large/wide glands treated with prostate seed implantation for localized adenocarcinoma of prostate.
OBJECTIVE
To analyze whether prostate size affects biochemical relapse-free survival (bRFS).


METHODS
The bRFS outcomes for 390 patients with a minimum of 2 years of follow-up were determined from a review of a prospectively maintained database. All patients were treated with iodine-125 alone as the radiotherapeutic modality and had a minimum of four posttreatment prostate-specific antigen values. None were treated with androgen deprivation. The factors examined in the univariate and multivariate analyses predicting for bRFS included gland volume, patient age, initial prostate-specific antigen value, biopsy Gleason score, clinical stage, and postimplant dosimetric variables.


RESULTS
Most patients had low-risk disease, and the median follow-up was 45 months (range 24 to 102). Using the American Society for Therapeutic Radiology Oncology definition of biochemical failure, the overall 5-year bRFS rate was 89.3%. On separate multivariate analyses, only the pretreatment prostate width and volume significantly influenced bRFS favorably (P = 0.0069 and P = 0.0255, respectively). No association was found between gland size/width and postimplant dosimetry.


CONCLUSIONS
The results of our study have shown that implantation of large/wide prostates independently confers better bRFS.
Quan
Aimee L
AL
Department of Radiation Oncology, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Ciezki
Jay P
JP
Reddy
Chandana A
CA
Angermeier
Kenneth
K
Ulchaker
James
J
Mahadevan
Arul
A
Chehade
Nabil
N
Altman
Andrew
A
De Oreo
Gerard
G
Klein
Eric A
EA
D000230:Adenocarcinoma / Q000097:blood* / Q000473:pathology / Q000532:radiotherapy; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D001706:Biopsy; D001918:Brachytherapy / Q000295:instrumentation*; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000473:pathology / Q000532:radiotherapy; D013997:Time Factors; D016896:Treatment Outcome
D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen