PSA Failure Predicts Death in Men With Low Comorbidity Burden
Findings among men with localized intermediate- and high-risk prostate cancer.
(HealthDay News) -- Prostate-specific antigen (PSA) failure is associated with increased risk of all-cause mortality for men with intermediate- or high-risk prostate cancer with no or minimal comorbidity, according to a study published online in the Journal of Clinical Oncology.
Nicholas J. Giacalone, MD, from Brigham and Women's Hospital in Boston, and colleagues examined whether PSA failure is associated with the risk of all-cause mortality stratified by comorbidity score. Two hundred six men with localized intermediate- and high-risk prostate cancer were randomized to receive radiation therapy or radiation therapy and 6 months of androgen deprivation therapy.
After a median follow-up of 16.62 years, the researchers found that 76% of the men died, and 19% of those men died as a result of prostate cancer. Among men with no or minimal comorbidity, PSA failure was associated with an increased risk of all-cause mortality (adjusted hazard ratio, 1.59; 95% confidence interval, 1.03 to 2.46; P = 0.04); this was not the case for men with moderate or severe comorbidity (adjusted hazard ratio, 1.75; 95% confidence interval, 0.76 to 3.99; P = 0.19).
"Recommending treatment on the basis of reduced PSA failure observed from early results of randomized controlled trials is unlikely to prolong survival in men with moderate-to-severe comorbidity but may prolong survival in men with no or minimal comorbidity, providing evidence to support discussing the early results with these men," the authors write.
One author disclosed financial ties to the biopharmaceutical industry.
1. Giacalone NJ, Wu J, Chen MH, Renshaw A, Loffredo M, Kantoff PW and D'Amico AV. Prostate-Specific Antigen Failure and Risk of Death Within Comorbidity Subgroups Among Men With Unfavorable-Risk Prostate Cancer Treated in a Randomized Trial. JCO 2016 Sept 6. doi: 10.1200/JCO.2016.68.4530.