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. 2012 Aug 1:7:127.
doi: 10.1186/1748-717X-7-127.

The role of the maximum involvement of biopsy core in predicting outcome for patients treated with dose-escalated radiation therapy for prostate cancer

Jure Murgic  1 , Matthew H Stenmark, Schuyler Halverson, Kevin Blas, Felix Y Feng, Daniel A Hamstra
Affiliations

The role of the maximum involvement of biopsy core in predicting outcome for patients treated with dose-escalated radiation therapy for prostate cancer

Jure Murgic et al. Radiat Oncol. .

Abstract

Purpose: To evaluate the influence of the maximum involvement of biopsy core (MIBC) on outcome for prostate cancer patients treated with dose-escalated external beam radiotherapy (EBRT).

Methods and materials: The outcomes of 590 men with localized prostate cancer treated with EBRT (≥75 Gy) at a single institution were retrospectively analyzed. The influence of MIBC on freedom from biochemical failure (FFBF), freedom from metastasis (FFM), cause-specific survival (CSS), and overall survival (OS) was compared to other surrogates for biopsy tumor volume, including the percentage of positive biopsy cores (PPC) and the total percentage of cancer volume (PCV).

Results: MIBC correlated with PSA, T-stage, Gleason score, NCCN risk group, PPC, PCV, and treatment related factors. On univariate analysis, MIBC was prognostic for all endpoints except OS; with greatest impact in those with Gleason scores of 8-10. However, on multivariate analysis, MIBC was only prognostic for FFBF (hazard ratio [HR] 1.9, p = 0.008), but not for FFM (p = 0.19), CSS (p = 0.16), and OS (p = 0.99).

Conclusions: In patients undergoing dose-escalated EBRT, MIBC had the greatest influence in those with Gleason scores of 8-10 but provided no additional prognostic data as compared to PPC and PCV, which remain the preferable prognostic variables in this patient population.

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Figures

Figure 1
Figure 1
(a) Correlation between maximum involvement of biopsy core (MIBC) and (a) percentage of positive cores (PPC) and (b) percentage of cancer volume (PCV).
Figure 2
Figure 2
Kaplan-Meier estimates of (a) freedom from biochemical failure, (b) freedom from metastasis, (c) cause-specific survival, and (d) overall survival as a function of maximum involvement of biopsy core (MIBC). Cut-point of 60% generated from receiver operating characteristic curve analysis.
Figure 3
Figure 3
Failure patterns for patient cohort based on Gleason 8–10 stratified by having less than or equal to 60% MIBC vs. greater than 60% MIBC. (a) FFBF. (b) FFM. (c) CSS (d) OS.
See this image and copyright information in PMC

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