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Hopkins researchers identify risk factors for prediction of lethal prostate cancer after recurrence

identify the risk factors, the researchers studied 379 patients treated with radical prostatectomy at Johns Hopkins between 1982 and 2000 who had a biochemical (PSA) recurrence - signs of prostate cancer revealed in blood tests - and had at least two PSA tests after recurrence that were separated by at least three months. The researchers found that the time for the PSA to double, the time from surgery to recurrence, and the Gleason score were significant risk factors for predicting time to death from prostate cancer recurrence and that patients could be divided into either a high-risk or a low-risk group. The categories include PSA doubling time (less then three months versus three to 8.9 months versus nine to 14.9 months versus 15 or more months), Gleason score, (seven or lower versus eight to 10), and time from surgery to biochemical recurrence (three years or under versus more than three years).

For example, patients with a PSA doubling time of less then three months (23 patients) had a median survival of six years. Patients with a PSA doubling time of less than three months, biochemical recurrence three or fewer years after surgery, and a Gleason score of eight to 10 (15 patients) had a median survival of three years. However, patients with a PSA doubling time of 15 months or more and a biochemical recurrence more than three years after surgery (82 patients) had a 100 percent survival. Using these three risk factors, the researchers then constructed tables to estimate the risk of prostate cancer-specific survival at five, 10, and 15 years after biochemical recurrence.

"We hope the tables will be useful to patients and their physicians for assessing the risk of death from prostate cancer following recurrence after surgery and guide the need for additional treatments," said Freedland.


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Contact: Trent Stockton
tstockt1@jhmi.edu
410-955-8665
Johns Hopkins Medical Institutions
26-Jul-2005


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