MP09-10 MULTI-INSTITUTIONAL PROSPECTIVE STUDY ASSESSING THE UNFAVORABLE SUBGROUP AMONG INTERMEDIATE-RISK LOCALIZED PROSTATE CANCER PATIENTS TREATED WITH RADICAL PROSTATECTOMY: IMPLICATIONS FOR PERSONALIZING TREATMENT OF RADICAL PROSTATECTOMY-MANAGED PATIENTS

You have accessJournal of UrologyProstate Cancer: Staging I (MP09)1 Apr 2019MP09-10 MULTI-INSTITUTIONAL PROSPECTIVE STUDY ASSESSING THE UNFAVORABLE SUBGROUP AMONG INTERMEDIATE-RISK LOCALIZED PROSTATE CANCER PATIENTS TREATED WITH RADICAL PROSTATECTOMY: IMPLICATIONS FOR PERSONALIZING TREATMENT OF RADICAL PROSTATECTOMY-MANAGED PATIENTS Youness AHALLAL*, Nicole Benfante, Matthieu Durand, Luis Felipe Snel Zanettini, Christiane Strauss, Alexandre Colau, Karim Touijer, and Bertrand Guillonneau Youness AHALLAL*Youness AHALLAL* More articles by this author , Nicole BenfanteNicole Benfante More articles by this author , Matthieu DurandMatthieu Durand More articles by this author , Luis Felipe Snel ZanettiniLuis Felipe Snel Zanettini More articles by this author , Christiane StraussChristiane Strauss More articles by this author , Alexandre ColauAlexandre Colau More articles by this author , Karim TouijerKarim Touijer More articles by this author , and Bertrand GuillonneauBertrand Guillonneau More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000555134.20723.69AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Patients with intermediate-risk prostate cancer (IR-PC) belong to a heterogeneous group with highly variable prognoses. The objective was to determine the pre-operative predictors of unfavorable oncological outcomes in IR-PC patients treated with radical prostatectomy and extended pelvic lymphadenectomy (RP-eLND) and compare oncological outcomes of unfavorable IR-PC to high-risk prostate cancer (HR-PC) patients. METHODS: Between 01/2012 and 02/2017, 2262 IR-PC and 981 HR-PC patients were consecutively included. Data were prospectively collected and extracted from our two institutional databases. Multivariate logistic regression analysis (MLRA) was used with forward stepwise variable selection to assess predictors of biochemical recurrence (BCR) and to define an unfavorable subgroup. Primary endpoint was BCR-free survival. RESULTS: 11% of IR-PC patients experienced BCR after 18.1 (8.2-62.1) months median follow-up. On MLRA assessing biopsy Gleason Score, number of positive biopsy cores (PBC) out of 12, bilaterality of lesions and extraprostatic extension on prostate MRI, only PBC ≥4 predicted disease recurrence (p=0.0002). In unfavorable IR-PC and HR-PC group respectively, 81% and 62% were disease-free after 18 (7.4-33.6) and 17.2 (5.3-31.7) months median (IQR) follow-up. When adjusted for pre-operative PSA, the unfavorable IR-PC group had still better oncological outcomes when compared to the HR-PC group in terms of BCR-free survival: HR: 3.40 (95% CI 2.90, 3.98; p<0.0001) CONCLUSIONS: According to our model, among patients with IR-PC, a number of PBC ≥4 out of 12 had a statistically significant correlation to adverse oncological outcomes. This subgroup of unfavorable IR-PC demonstrated worst oncological outcomes when compared to those of favorable IR-PC patients and still had better ones when compared to those of HR-PC patients treated with RP-ePLND. To our knowledge, this is the first study to stratify the IR-PC group into favorable and unfavorable subgroups according to BCR-free survival. These results are important to consider when counselling such patients for their disease management. Source of Funding: none Nice, France; New York, NY; Nice, France; Paris, France; New York, NY; Paris, France© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e111-e111 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Youness AHALLAL* More articles by this author Nicole Benfante More articles by this author Matthieu Durand More articles by this author Luis Felipe Snel Zanettini More articles by this author Christiane Strauss More articles by this author Alexandre Colau More articles by this author Karim Touijer More articles by this author Bertrand Guillonneau More articles by this author Expand All Advertisement PDF downloadLoading ...