Psa doubling time survival rate trial#

The life expectancy of an older patient, such as a 78-year-old, may be 5 to 10 years. For a 12-month PSADT and PSA level of 10 ng/mL, I would probably not treat but have a long discussion with the patient. I would evaluate comorbidities, and if they were low I might treat. A 6-month doubling time in the 10 to 20-ng/mL PSA range is a gray area. With less than a 3-month doubling time I would administer androgen deprivation therapy (ADT) to the 65-year-old patient with a PSA level of 10- ng/mL. Available at, identifier NCT00110162, last updated August 6, 2013.Answer: PSADT <3 mo?: Yes PSADT 6 mo?: Maybe PSADT 12 mo?: No Androgen deprivation therapy in treating patients with prostate cancer. Garcia-Albeniz X, Chan JM, Paciorek AT, et al: Immediate versus deferred initiation of androgen deprivation therapy in prostate cancer patients with PSA-only relapse. в– Дisclosure: The study authors reported no potential conflicts of interest.ДЎ. We need to wait for the gold standard,вЂќ Dr.

This study wonвЂ™t change clinical practice, but it might help men make decisions. We can use this information from an observational study in our discussions with patients. In real practice, we donвЂ™t have the answers to the question yet. вЂњIdeally we base treatment decisions on randomized trials.

Psa doubling time survival rate trial#

He looks forward to results of the large randomized trial studying this issue. Although the best statistical resources were used to adjust for prognostic differences between strategies, we still rely on the assumption of absence of unmeasured confounding factors. Ten-year survival was identical in both groups: 71.6%.ДЄs with every observational study, this investigation has limitations, Dr. Five-year survival rates were 87.2% (95% confidence interval = 84.5%вЂ“90.0%) for the deferred androgen deprivation therapy group and 85.1% (95% CI = 77.6%вЂ“92.7%) for those treated with immediate androgen deprivation therapy. There were 176 deaths recorded during follow-up 37 were due to prostate cancer. Median age was 69 years (range, 63 to 74 years) 33.8% had a Gleason score >В 7 and 31.8% received radiation as primary treatment. Median follow-up after PSA relapse was 41 months. Median time from primary treatment to PSA relapse was 27 months. The evaluated strategies were (1) immediate androgen deprivation therapy (within 3 months of rising PSA) and (2) deferred androgen deprivation therapy (at least 2 years after PSA-only relapse, or when they had metastasis, symptoms, or short PSA doubling time). These patients were treated in usual practice settings. Patients had to be asymptomatic and without evidence of metastasis. PSA relapse was defined as в‰ҐВ 0.02В ng/mL if treated with radical prostatectomy or three rising PSA levels 1 month apart if primary treatment was radiation-based.

Among these patients, 2,012 men experienced a PSA-only relapse following curative surgery or radiation. The study analyzed data on more than 14,000 patients included in a prospective registry called CaPSURE (Cancer of the Prostate Strategic Urologic Research Endeavor, based at the University of California, San Francisco). The results of that trial will answer the question and serve as the gold Вstandard.вЂќ Obviously, this is an observational study with several limitations, and the issue of when to start is being studied in an ongoing randomized phaseВ III trial. вЂњThese findings suggest that there may be no need to rush to. The guidelines say that the role of in this setting is a вЂtherapeutic dilemma,вЂ™вЂќ noted lead author Xabier Garcia-ВAlbeniz, MD, a research associate at the Harvard University School of Public Health in Boston. вЂњImmediate vs deferred androgen deprivation therapy for men with a PSA-only recurrence is a grey area. The study was presented at the 2014 ASCO Annual Meeting. These results of a large, population-based study, developed jointly by the Harvard School of Public Health and University of California, San Francisco, are suggestive and can be included in discussions with patients, but they are by no means definitive, say experts. In men with prostate cancer and a prostate-specific antigen (PSA)-only recurrence after curative surgery or radiation, delaying androgen deprivation therapy for at least 2 years or until clinical progression (ie, new symptoms, metastasis by imaging techniques or short PSA doubling time) did not appear to impact survival or prostate cancerвЂ“specific survival compared with immediate initiation of androgen deprivation therapy within 3 months of PSA-only recurrence. Immediate vs Deferred Androgen Deprivation