Factors associated with poor survival outcomes in prostate cancer (pca) patients with radiographic disease progression in the setting of low psa

You have accessJournal of UrologyCME1 Apr 2023MP29-20 FACTORS ASSOCIATED WITH POOR SURVIVAL OUTCOMES IN PROSTATE CANCER (PCA) PATIENTS WITH RADIOGRAPHIC DISEASE PROGRESSION IN THE SETTING OF LOW PSA Mohamed Ahmed, Jack Andrews, Ahmed Mahmoud, Matthew Lee, Elizabeth Bearrick, Daniel Childs, A. Tuba Kendi, Matthew Tollefson, Stephen Boorjian, R. Jeff Karnes, and Eugene Kwon Mohamed AhmedMohamed Ahmed More articles by this author , Jack AndrewsJack Andrews More articles by this author , Ahmed MahmoudAhmed Mahmoud More articles by this author , Matthew LeeMatthew Lee More articles by this author , Elizabeth BearrickElizabeth Bearrick More articles by this author , Daniel ChildsDaniel Childs More articles by this author , A. Tuba KendiA. Tuba Kendi More articles by this author , Matthew TollefsonMatthew Tollefson More articles by this author , Stephen BoorjianStephen Boorjian More articles by this author , R. Jeff KarnesR. Jeff Karnes More articles by this author , and Eugene KwonEugene Kwon More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003257.20AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Recent studies, including a post-hoc analysis of the ARCHES trial, highlight radiographic disease progression (rDP) occurring without concordant rise in prostate specific antigen (PSA). In a previous study by our group, we reported that almost 40% of patients on 2nd generation hormone therapy experience rDP with non-rising PSA and have poor survival outcomes. The current analysis more specifically focuses on the subgroup of patients with rDP occurring at low PSA (<0.5 ng/dL) and describes factors associated with poorer survival outcomes in this patient population. METHODS: In a single institution study, we reviewed the prospectively maintained Mayo Clinic C-11 Choline PET registry for patients treated between 2011 and 2021, who experienced rDP at low PSA (value < 0.5 ng/mL). Disease progression on C-11 choline PET was confirmed by either tissue biopsy or subsequent response to therapy. We investigated factors associated with poor cancer-specific survival outcomes in univariable and multivariable cox regression analyses. RESULTS: In total, 220 (16%) patients experiencing rDP at low PSA were identified. Median (IQR) age at rDP was 67.91 (61.10 – 73.87) yrs., median (IQR) primary Gleason score was 9 (7-9), and median (IQR) PSA was 0.17 (0 – 0.32) ng/ml. 75% of the patients (n=166) had CRPC disease status at time of rDP. Prior systemic treatments included 2nd generation HT in 18% (n= 40) and chemotherapy in 31% (n=70). Sites of rDP were divided into 7% local (n=16), 42% lymph nodes (n=91), 43% bone (n=95), and 8% visceral metastases (n=18). Over a median follow-up duration of 55 months, 46% of patients (n=100) reported death. Factors associated with poor survival outcomes are demonstrated in table-1 and include age at rDP, CRPC status, and disease location (P-value <0.05). CONCLUSIONS: We found that radiographic disease progression commonly occurs at low PSA (<0.5 ng/mL). CRPC-disease status and the development of visceral metastases are associated with particularly poor survival outcomes. To identify early progression, monitoring with imaging may be warranted, even in the patients with low PSA. Source of Funding: none © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e390 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mohamed Ahmed More articles by this author Jack Andrews More articles by this author Ahmed Mahmoud More articles by this author Matthew Lee More articles by this author Elizabeth Bearrick More articles by this author Daniel Childs More articles by this author A. Tuba Kendi More articles by this author Matthew Tollefson More articles by this author Stephen Boorjian More articles by this author R. Jeff Karnes More articles by this author Eugene Kwon More articles by this author Expand All Advertisement PDF downloadLoading ...