How common are late recurrences?

New Topic Post Reply Printable Version
45 posts in this thread.
Viewing Page :
 1  2 
[ << Previous Thread | Next Thread >> ]

Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 10/15/2010 1:09 PM (GMT -6)   
Two of my friends have experienced very late PCa recurrences.  One was about 15 years after SRT and the other was 17 years after BT.  Just how common is this?  Can anyone provide a link or some data about the frequency of late recurrences?  It seems that just about the time I get comfortable with my outcome, these things seem to crop up.
 
Carlos

Diagnosed 2/2008 at age 71, PSA 9.1, Gleason score 5+3, stage T1c.
Robotic surgery 5/2008, LFPF at 6 wks.,nerves spared, stg. pT2c, N0, MX, R0, Gleason 5+3
PSA <0.1 at 26 months and at all tests since surgery.

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 10/15/2010 1:20 PM (GMT -6)   
Carlos,
More common than I would like to see. It has always been my contention that 10 years studies are almost useless in prostate cancer. Very few men die of prostate cancer in the first decade after Dx. And that is good news for the median aged man at Dx. But for the guys well under that age, surviving prostate cancer is a different ballgame. My best friend here in Vegas has a father who is a survivor. He was diagnosed with an unknown Gleason in 1981 at the age of 54 and had a radical prostatectomy with orchiectomy. It was 29 years later earlier this year that it was discovered that his bladder was infested with the disease at Gleason 10. That is my longest time frame for relapse that I know of.

Tony
Disease:
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
RALP ~ 2/17/2007 at the City of Hope near Los Angeles.
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.

Status:
"I beat up this disease and took its lunch money! I am in remission."
I am currently not being treated, but I do have regular oncology visits.
I am the president of an UsTOO chapter in Las Vegas

Blog : www.caringbridge.org/visit/tonycrispino

Zen9
Regular Member


Date Joined Oct 2009
Total Posts : 310
   Posted 10/15/2010 1:57 PM (GMT -6)   

Dr. Scardino has written on several occasions that biochemical recurrence after seven years is "rare."  For example:

 "Disease recurrence beyond the 7-year point is rare in our series.11"

The link to the entire article is:

http://jco.ascopubs.org/content/17/5/1499.full?ijkey=940fa0c330c55b370fb0581f462744ac77795689

Zen9


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 10/15/2010 2:25 PM (GMT -6)   
Zen,
That study you quoted was completed in 1999 and set the basis for the nomograms used today by MSK. These nomograms have underwent many changes since this study including a 10 year probability of recurrence. The high end case in this study was 164 months and the median was 36 months.

Back to my statement in that this study is incomplete in referencing prostate cancer 11 years and beyond... And it has since changed quite a bit...

Tony
Disease:
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
RALP ~ 2/17/2007 at the City of Hope near Los Angeles.
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.

Status:
"I beat up this disease and took its lunch money! I am in remission."
I am currently not being treated, but I do have regular oncology visits.
I am the president of an UsTOO chapter in Las Vegas

Blog : www.caringbridge.org/visit/tonycrispino

Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 10/15/2010 2:59 PM (GMT -6)   
Tony, Zen  Thanks for the replies and link.  From the link Zen provided, it would appear that if one's PSA remains undetectable for 5 to 7 years, it would be rare to have a recurrence.  As usual, high gleason scores seem to have a large impact also.  Again, thanks for the replies.
 
Carlos
 

Zen9
Regular Member


Date Joined Oct 2009
Total Posts : 310
   Posted 10/15/2010 4:30 PM (GMT -6)   

Tony,

As I clearly stated, Dr. Scardino has put forth his seven year rule of thumb on several occasions, not just the one paper in 1999.  That happens to be the only one I have bookmarked.

It is difficult to respond to the rest of your post, since you bounce back and forth between death from PCa and biochemical recurrence, which are too very different things (particularly to the patient smilewinkgrin ).  I understood Carlos to be asking about the latter.

Carlos,

I think your summary is a reasonably good one.  I would just add that - to state the obvious - "rare" is not the same thing as "impossible."  Hence Tony's 29-year example.

Peace,

Zen9


ChrisR
Veteran Member


Date Joined Apr 2008
Total Posts : 825
   Posted 10/15/2010 6:28 PM (GMT -6)   
According to this study not that common.

http://esciencenews.com/articles/2010/09/29/surgery.offers.long.term.survival.early.stage.prostate.cancer.patients

I don't know

Mike E
Regular Member


Date Joined Oct 2009
Total Posts : 23
   Posted 10/15/2010 7:17 PM (GMT -6)   
This topic is the hardest part of everything I have been through. I just passed the 1 year mark and am still in the 0 club (Thank God!). However, I never realized that this is an ongoing battle. I guess I thought having a prostatectomy was kind of like appendicitis--once it is out, it is gone forever. I try not to dwell on it, but over the months, the nagging fear is growing in my mind. The big complication for me is that I had a Gleason 9, though, no evidence that it escaped the capsule. Should I just get used to the idea that I will probably end up facing this again at some point in the future? I don't mean to sound morbid. I am just trying to wrap my mind around this new realization. Thanks for any insight. (I don't post very much, but I do check in and pray for guys that are really suffering. I guess I am not much of a "talker.")
Age 56 at surgery
After several years of being treated for on and off prostatitis, my PSA stopped responding to Cipro...
PSA: 2.56 (up from 1.6 over a year and a half)
Bone Scan: negative
Biopsy: 8/21/09 6/12 plugs were positive for cancer
open RRP done at Johns Hopkins: 10/7/09
Upgraded Gleason to 4+5 = 9 (from an 8)
Tumor extent: Moderate
Margins: Positive 1 mm
Extraprostatic Extension: could not be distinguished because of incision site
No seminal vesicle or lymphatic invasion
Stage: pT2x
11/21: Incontinence- mostly dry at night, but little progress during the day, multiple pads
ED: Nothing but fleeting twinges of hope every now and then
7/4/10: Incontinence - dry at night, can manage without pads when working from home; one pad per day when at office, etc. (Sometimes two, if lots of standing, walking, etc.)
ED: Modest success with 100 mg. Viagra

livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 10/16/2010 5:48 AM (GMT -6)   
this is an interesting thread and obviously opinions vary as much as prostate cancer itself. It has been my contention from day one to just do what I can do to keep my self healthy and focused. There are too many studies out there for me to try and figure out. Thanks to you guys who do dissect them for us.

peace to you
dale
My PSA at diagnosis was 16.3
age 47 (current)

http://www.caringbridge.org/visit/dalechildress

My gleason score from prostate was 4+5=9 and from the lymph nodes (3 positive) was 4+4=8
I had 44 IMRT's
I was on Lupron, Casodex, and Avodart for two years with my last shot March 2009. I am currently (7-22-2010) not on any medication.
My Oncology hospital is The Cancer Treatment Center of America in Zion IL
PSA July of 2007 was 16.4
PSA May of 2008 was.11
PSA July 24th, 2008 is 0.04
PSA Dec 16th, 2008 is .016
PSA Mar 30th, 2009 is .02
PSA July 28th 2009 is .01
PSA OCt 15th 2009 is .11
PSA Jan 15th 2010 is .13
PSA April 16th of 2010 is .16
PSA July 22nd of 2010 is .71
Testosterone keeps rising, the current number is 156, up from 57 in May

T level dropped to 37 Mar 30th, 2009
cancer in 4 of 6 cores
92%
80%
37%
28%

ChrisR
Veteran Member


Date Joined Apr 2008
Total Posts : 825
   Posted 10/16/2010 5:52 AM (GMT -6)   
Reedy

Did your dr. give you any idea of how much cancer you had. I also had RP at JH. I had tumor volume as moderate. Epstien told me it means not that much.  I have read that JH says measuring tumor volume is time consuming and difficult to do accurately. They also say there is. Not much prognastic value in it. I was just curious if moderate related to a volume cut off point like less then .5cc or something. Did your dr. elaborate on it?

Post Edited (ChrisR) : 12/28/2010 7:08:24 PM (GMT-7)


NEIrish
Regular Member


Date Joined Aug 2010
Total Posts : 245
   Posted 10/16/2010 6:38 AM (GMT -6)   
First to Reedy: Welcome to one of the most helpful forums for info and support of a miserably confusing cancer.  Second: Congrats on the zero reading, and wishing you many more!  Third: My husband was thinking more or less the same thing: "I had cancer, they took it out, I don't have cancer anymore." 3 months of a great post Dx, pre-surgery diet and the addition of daily ground flaxseed has gradually slipped back to more red meat, higher fats overall, and rare flaxseed additions.  I've had to gently, then more firmly remind him that there are still prostate cells in his body, vulnerable to "going over to the dark side".  I would say to you what I say to him:  We don't know what will be coming down the pike, so we're going to welcome each day with gratitude and joy (and healthy lifestyle):-) and leave the future alone. Much easier to say than to do, but with what you and he have lived through so far, you can do anything you set your minds to...

Mike E
Regular Member


Date Joined Oct 2009
Total Posts : 23
   Posted 10/16/2010 7:04 AM (GMT -6)   
Thanks for the comments ChrisR. The only thing I see on my path report about volume is moderate. (The pre-surgery biopsy report show 40% cancer in one of the cores, if that helps answer your question.) My primary tumor was a 9 and the secondary one was a 6. Have you had much follow-up at JH? I haven't felt like that is a strong point for them--at least with my doc.

Mike E
Regular Member


Date Joined Oct 2009
Total Posts : 23
   Posted 10/16/2010 7:09 AM (GMT -6)   
Thank you for the encouraging word, NEIrish! You would get along great with my wife. Most days I am way too busy to think much about PCa, but strangely, every once in a while I wake up struggling with it. Maybe it has something to do with my one year anniversary. Anyway, I get what you are saying and give a hearty AMEN. My best to you and your husband.

PS Your comments about healthy lifestyle are right on. It is so easy to fall back into old (poor) habits.

ChrisR
Veteran Member


Date Joined Apr 2008
Total Posts : 825
   Posted 10/16/2010 7:51 AM (GMT -6)   
Not really any followup from them yet I did not have any problems.
Dx 42
Gleason 6 (tertiary score 0)

open RP 10/08 Johns Hopkins

pT2 Organ confined Gleason 6

PSA
10/15/2009 <.1
10/15/2010 <0.03
10/15/2011 -

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4229
   Posted 10/16/2010 3:07 PM (GMT -6)   
Most reoccurrances occur in the 1st 5 years. All treatment reoccurrance rates flatline or drop at 5 years with the exception of HIFU which remains steady. There is nothing I have ever seen that supports that reoccurrance rates rise at 5, 10, or 20 years regardless of treatment. The longer you go without a reocccurrance the less chance you have of getting one. There will always be some long term reoccurrances and I suspect that these are systemic and not due to any failed treatment. Some cancer cells excape into the bloodstream and depending on genetics, imune systems and lifestyle they at some point decide to grow. Since these are already outside the scaple or radiation beam at time of treatment they are not treatment related. If they were we would have many more cases of localized PC with long term reoccurrances.
A local reoccurrance occurs when prostate tissue is left behind or a positive margin leaves pc cells in the prostate bed. In radiation it occurs when the dose is not high enough or when there are dead spots in the delivery. These cells are left intact and continue to grow at their genetic programmed rate. These usually indicate themselves by rising psa within 5 years of treatment or as soon as the cell popluation grows enough to generate detectable psa.
JT
65 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, no side affects and psa .1 at 1.5 years.

Terry Herbert
Regular Member


Date Joined Sep 2010
Total Posts : 92
   Posted 10/16/2010 3:23 PM (GMT -6)   
The longest study I have seen is a Swedish study which ran for 20 years (and is still running as far as I know. The last aricle I saw that shows biochemical recurrence can occur at 20 years, but the majority of recurrences are in the first five years.

The one thing about this disease is that there is no certainty
Diagnosed ‘96: Age 54: Stage T2b: PSA 7.2: Gleason 7: No treatment. Jun '07 PSA 42.0 - Bony Metastasis: Aug '07: Intermittent ADT: PSA 2.3 Aug '10

It is a tragedy of the world that no one knows what he doesn’t know, and the less a man knows, the more sure he is that he knows everything. Joyce Carey

Mike E
Regular Member


Date Joined Oct 2009
Total Posts : 23
   Posted 10/17/2010 6:05 AM (GMT -6)   
Thanks for all the great feedback on this topic. It has been very therapeutic. It seems to me that the bottom line is to take each day as it comes, live life to the fullest, and trust in God. Worrying never added a single day to anyone's life

post edited, removing scripture cite. Rule 11, which says, in part, Limited religious references are allowed (ie. "my prayers are with you" or a brief quote as part of a larger post), but the forums should not be used to convert others.

Post Edited By Moderator (James C.) : 10/17/2010 7:18:52 AM (GMT-6)


ChrisR
Veteran Member


Date Joined Apr 2008
Total Posts : 825
   Posted 10/17/2010 7:07 AM (GMT -6)   
moderator please edit the above post.

Zen9
Regular Member


Date Joined Oct 2009
Total Posts : 310
   Posted 10/17/2010 11:46 AM (GMT -6)   
John T (and anyone else):

OK, now I'm confused again. I put the question to the board about six months ago - rule of thumb (not carved in stone ...), everything else being equal, if you have biochemical recurrence within the first few years (as opposed to way down the road), is it more likely to be local or metastatic?

The answer I got was that other things being equal, early recurrences after surgery are more likely to be metastatic, later ones more likely to be local. Again, rule of thumb only. Some people responding included links to articles supporting that position.

I read your post as suggesting that early recurrences are more likely to be local, later ones more likely to be metastatic. Am I misreading your post? And in any event which is it? Anyone?

Thanks very much.

Zen9

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4229
   Posted 10/17/2010 1:09 PM (GMT -6)   
Zen,
There isn't a 100% answer only generalities. If psa doesn't go down immediately after treatment to levels that are considered curable then the reoccurrance is most likely systemic because psa is being generated elsewhere in the body and not in the prostate. Since about 30% of reoccurrances are cured by salvage therapies then we have to conclude that 70% of all reoccurrances are systemic. A local reoccurrance should always result in a rising psa with a short period after treatment, because cells are still growing in the prostate tissue. A systemic reoccurrance can lay dormant for years. I'm assuming that the vast majority of late stage reoccurrances are systemic because of how the cancer acts and most cases I have heard about entail wide spread PC.
JT
65 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, no side affects and psa .1 at 1.5 years.

Zen9
Regular Member


Date Joined Oct 2009
Total Posts : 310
   Posted 10/17/2010 1:56 PM (GMT -6)   
John T,

Thanks for your quick response. So then you disagree with these representative answers I got to the same question posted earlier this year:

MichGuy (2/9/10): "Zen9, I haven't posted in quite a while, but I just saw your question wasn't really answered. My understanding is that the longer it takes for biochemical recurrence after surgery, the more likely it is that it is a local recurrence. It seems to me that a metastatic recurrence wouldn't necessarily have any timeframe relationship to surgery. So, if you have metastatic disease present, and then you have surgery, your PSA would drop as a result of the removal of the prostate, but your metastatic cancer would continue to increase PSA and be evident soon after surgery. On the other hand, if you didn't have metastatic disease, then after your prostate was removed, your PSA would drop significantly and any cancerous prostate tissue "left behind" would need time to grow to increase its PSA and become evident as a recurrence. This could take years perhaps, however it would still be local."

Casey59 (2/9/10): "MichGuy, you got it basically correct.

For this more detailed response, I refer to Dr Patrick Walsh's book, "Guide to Surviving Prostate Cancer", and specifically to the chapter "How Successful Is Treatment of Localized Prostate Cancer, and the sub-section on "What Should I Do If My PSA Comes Back After Surgery"...

Walsh references a study by Alan Partin which characterized men post-surgically prone to either local recurrence or distant metastases. Keep in mind that these were simply characterizations and not definative. The findings were:
Men prone to distant metastases generally have one or more of the following characteristics:

Gleason scores of 8 or higher,
cancer found in their seminal vesicles and lymph nodes during surgery, or
rise in PSA within a year after surgery.
Men more likely to have local recurrence of PC had one or more of the following:

Gleason scores of 7 or less,
no cancer found in seminal vesicles and lymph notes, or
increases in PSA several years after surgery.
--------------------------

I agree that the time-based element of MichGuy's response is basically correct; that is, the small amount of PC cells left behind locally may need some time to multiply enough times to produce measureable amounts of PSA in the bloodstream."

LV-TX (2/10/10): "So the short answer...if the psa comes back after being undetectable and there is no lymph node or seminal invasion, the disease can be considered local. This is the reason most surgeons want a psa test shortly after surgery, usually within 3 months."

Thanks again. I am really confused about this.

Again, the question is: all other things being equal, is a BCR years down the road more or less likely to be a local recurrence than a BCR shortly after surgery? I fully realize that each case is unique, I am asking statistically.

Zen9

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4229
   Posted 10/17/2010 5:01 PM (GMT -6)   
Zen,
I basically agree with what what everyone said when the reoccurrance is less than 5 years. For very long term reoccurrances I think it may be different. This is the reason for my thinking: If the reoccurrance were local then it would occur quickly, within years, because there has nothing that has been done to change the nature of the cancer cells. When cells circulate in the bloodstream it may take years for them to find a place to grow. I don't have any specific evidence to support this and I imagine that some very long term reoccurrances can occur locally.
It's an interesting question and it would be good to see some data on very long term reoccurrances.
JT
65 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, no side affects and psa .1 at 1.5 years.

Zen9
Regular Member


Date Joined Oct 2009
Total Posts : 310
   Posted 10/17/2010 5:08 PM (GMT -6)   
John T,

I appreciate your quick responses, but I am still very confused. Probably just getting old ....

Anyone else care to weigh in?

Zen9

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4229
   Posted 10/17/2010 5:14 PM (GMT -6)   
This was published by the Mayo clinic:
Abstract
PURPOSE: Information regarding the clinical impact of delayed (5 years or greater) biochemical failure (BF) after radical prostatectomy (RP) is lacking. We undertook an investigation to differentiate the innocuous recurrence of serum prostate specific antigen (PSA) from that which heralds an eventual clinical failure (CF), and to determine if there is a period following RP when a patient is cured of clinical disease.

MATERIALS AND METHODS: Men with clinically localized prostate cancer (PCA) undergoing RP (1987 to 1995) were identified from our longitudinal PCA registry. Outcome measurements were based on the detection of post-RP serum PSA 0.4 ng/ml or greater, clinical identification of cancer recurrence and disease related death.

RESULTS: Following RP in 3,903 eligible men, 33% had a detectable PSA (median followup 8.8 years). Of these BFs 27% occurred after 5 or more disease-free years. Currently, 29% of all men with BF have clinical evidence of PCA, with 8% dying of PCA (median actuarial survival time from CF to death 9.8 years). Progression from BF to CF was not significantly altered by the disease-free interval (p = 0.544). A PSA doubling time less than 12 months significantly increased the risk of CF regardless of the interval from surgery. Risk factors for BF were significant throughout the duration of followup.

CONCLUSIONS: Patients are at prolonged risk for BF and CF following RP. Regardless of the timing of the initial PSA recurrence the PSA doubling time is the most powerful predictor of progression, stratifying patients with BF into high and low risk groups for CF.

PMID: 14532796 [PubMed - indexed for MEDLINE]


MeSH Terms, SubstancesMeSH Terms:AdultAgedAged, 80 and overCohort StudiesDisease ProgressionDisease-Free SurvivalFollow-Up StudiesHumansMaleMiddle AgedNeoplasm Recurrence, Local/bloodNeoplasm Recurrence, Local/diagnosis*Neoplasm Recurrence, Local/mortalityNeoplasm StagingProstate/pathologyProstate-Specific Antigen/blood*Prostatectomy*Prostatic Neoplasms/bloodProstatic Neoplasms/mortalityProstatic Neoplasms/surgery*Risk FactorsSurvival RateTreatment FailureTumor Markers, Biological/blood*Substances:Tumor Markers, BiologicalProstate-Specific Antigen
LinkOut - more resourcesFull Text Sources:Elsevier ScienceEBSCOOhioLINK Electronic Journal CenterOvid Technologies, Inc.Swets Information ServicesOther Literature Sources:COS Scholar UniverseMedical:Prostate Cancer - MedlinePlus Health InformationSupplemental Content
Related citations
PSA doubling time as a predictor of clinical progression after biochemical failure following radical prostatectomy for prostate cancer. [Mayo Clin Proc. 2001]
PSA doubling time as a predictor of clinical progression after biochemical failure following radical prostatectomy for prostate cancer.
Roberts SG, Blute ML, Bergstralh EJ, Slezak JM, Zincke H.
Mayo Clin Proc. 2001 Jun; 76(6):576-81. Review Markers and meaning of primary treatment failure. [Urol Clin North Am. 2003]
Review Markers and meaning of primary treatment failure.
Swindle PW, Kattan MW, Scardino PT.
Urol Clin North Am. 2003 May; 30(2):377-401. Is preoperative serum prostate-specific antigen level significantly related to clinical recurrence after radical retropubic prostatectomy for localized prostate cancer? [BJU Int. 2006]
Is preoperative serum prostate-specific antigen level significantly related to clinical recurrence after radical retropubic prostatectomy for localized prostate cancer?
Haukaas SA, Halvorsen OJ, Daehlin L, Hostmark J, Akslen LA.
BJU Int. 2006 Jan; 97(1):51-5. Stratification of patient risk based on prostate-specific antigen doubling time after radical retropubic prostatectomy. [Mayo Clin Proc. 2007]
Stratification of patient risk based on prostate-specific antigen doubling time after radical retropubic prostatectomy.
Tollefson MK, Slezak JM, Leibovich BC, Zincke H, Blute ML.
Mayo Clin Proc. 2007 Apr; 82(4):422-7. Review [PSA and follow-up after treatment of prostate cancer] [Prog Urol. 2008]
Review [PSA and follow-up after treatment of prostate cancer]
Benchikh El Fegoun A, Villers A, Moreau JL, Richaud P, Rebillard X, Beuzeboc P.
Prog Urol. 2008 Mar; 18(3):137-44. Epub 2008 Apr 18.See reviews...

See all...

Cited by 3 PubMed Central articles
Challenges in clinical prostate cancer: role of imaging. [AJR Am J Roentgenol. 2009]
Challenges in clinical prostate cancer: role of imaging.
Kelloff GJ, Choyke P, Coffey DS, Prostate Cancer Imaging Working Group.
AJR Am J Roentgenol. 2009 Jun; 192(6):1455-70. Prostate tumor growth and recurrence can be modulated by the omega-6:omega-3 ratio in diet: athymic mouse xenograft model simulating radical prostatectomy. [Neoplasia. 2006]
Prostate tumor growth and recurrence can be modulated by the omega-6:omega-3 ratio in diet: athymic mouse xenograft model simulating radical prostatectomy.
Kelavkar UP, Hutzley J, Dhir R, Kim P, Allen KG, McHugh K.
Neoplasia. 2006 Feb; 8(2):112-24. Postoperative nomogram predicting the 10-year probability of prostate cancer recurrence after radical prostatectomy. [J Clin Oncol. 2005]
Postoperative nomogram predicting the 10-year probability of prostate cancer recurrence after radical prostatectomy.
Stephenson AJ, Scardino PT, Eastham JA, Bianco FJ Jr, Dotan ZA, DiBlasio CJ, Reuther A, Klein EA, Kattan MW.
J Clin Oncol. 2005 Oct 1; 23(28):7005-12. All links from this record
Related Citations
Calculated set of PubMed citations closely related to the selected article(s) retrieved using a word weight algorithm. Related articles are displayed in ranked order from most to least relevant, with the “linked from” citation displayed first.Cited in PMC
Full-text articles in the PubMed Central Database that cite the current articles.Cited in Books
NCBI Bookshelf books that cite the current articles.
65 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, no side affects and psa .1 at 1.5 years.

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4229
   Posted 10/17/2010 5:27 PM (GMT -6)   
I'm beginning to change my mind about long term reoccurrances; here's a study from Germany published in European Urology:
Objectives: The ultimate outcome of patients after radical prostatectomy is often predicted from statistical projections of short-term follow-up. Only actual long-term follow-up can demonstrate true outcome.

Methods: One hundred thirty-one patients underwent retropubic prostatectomy for clinically organ confined prostate cancer and have been followed for a minimum of 22.5 years. Preoperatively, all but 12 had clinically palpable cancer.

Results: Overall survival in these patients was similar to an age-matched population, with 65% alive at 15 years, and 23% alive at 25 years. Thirty-seven percent of the patients recurred and 24% of all the patients died of prostate cancer. For patients with pathologically organ confined disease, 27% recurred, while those with extension outside the gland or positive nodes had an 83% recurrence rate. Although, the median time to recurrence was 7 years, recurrences occurred at a steady-state throughout the length of follow-up. Patients with higher grade tumors, even if organ confined, were significantly more likely to recur.

Conclusions: In a cohort of patients treated with radical prostatectomy for predominantly palpable disease, long-term follow-up (79% deceased) reveals that 37% will recur and 24% will die of prostate cancer. Almost half the recurrences occurred after 10 years, indicating that reports with shorter follow-up will underestimate the recurrence rate.
65 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, no side affects and psa .1 at 1.5 years.
New Topic Post Reply Printable Version
45 posts in this thread.
Viewing Page :
 1  2 
Forum Information
Currently it is Monday, June 25, 2018 11:20 AM (GMT -6)
There are a total of 2,975,054 posts in 326,238 threads.
View Active Threads


Who's Online
This forum has 161322 registered members. Please welcome our newest member, exlibris.
454 Guest(s), 9 Registered Member(s) are currently online.  Details
borrelioburgdorferii, BnotAfraid, Balladeer, Girlie, Bull101, Ticsic, jdiane, Tall Allen, joee