Biochemical outcomes and predictive factors by risk group after permanent iodine-125 seed implantation: Prospective cohort study in 2,316 patients

Norihisa Katayama, Katsumasa Nakamura, Atsunori Yorozu, Takashi Kikuchi, Masanori Fukushima, Shiro Saito, Takushi Dokiya

Research output: Contribution to journalArticle

Abstract

Purpose: To evaluate the biochemical freedom from failure (bFFF)by risk group and treatment modality and the predictive factors of bFFF by risk group in patients with prostate cancer undergoing permanent seed implantation (PI)with or without external beam radiation therapy (EBRT)in a nationwide prospective cohort study (Japanese Prostate Cancer Outcome Study of Permanent Iodine-125 [I-125]Seed Implantation)in Japan during the first 2 years. Methods and Materials: The analyses included 2,316 participants in 42 institutions; bFFF was evaluated using the Phoenix definition and calculated using the Kaplan–Meier method, and the Cox proportional hazards model was used to identify the factors associated with bFFF. Results: Median followup period was 60.0 months. The 5-year bFFF rates in all patients, 1,028 low-risk patients, 1,114 intermediate-risk patients, and 133 high-risk patients were 93.6%, 94.9%, 92.7%, and 91.1%, respectively. The 5-year bFFF rates in the PI group and EBRT combination therapy group were 93.7% and 93.3%, respectively. In a multivariate analysis, younger age, higher Gleason score (GS), higher percent positive biopsies (%PB), and lower prostate V100 (p = 0.0012, 0.0030, 0.0026, and 0.0368)in all patients; younger age, higher pretreatment prostate-specific antigen, and lower prostate V100 (p = 0.0002, 0.0048, and 0.0012)in low-risk patients; higher GS, higher %PB, and no hormonal treatment (p = 0.0005, 0.0120, and 0.0022)in intermediate-risk patients; and higher GS and higher %PB (p = 0.0329 and 0.0120)in high-risk patients were significantly associated with bFFF. Conclusions: PI with or without EBRT resulted in excellent short-term biochemical outcomes in all risk groups, especially in high-risk patients. Age, pretreatment prostate-specific antigen, and prostate V100 in low-risk patients; GS, %PB, and hormonal treatment in intermediate-risk patients; and GS and %PB in high-risk patients were independently affected bFFF.

Original languageEnglish
JournalBrachytherapy
DOIs
Publication statusPublished - Jan 1 2019

Fingerprint

Iodine
Seeds
Cohort Studies
Prospective Studies
Neoplasm Grading
Prostate
Radiotherapy
Prostate-Specific Antigen
Prostatic Neoplasms
Group Psychotherapy
Proportional Hazards Models
Japan
Therapeutics
Multivariate Analysis
Outcome Assessment (Health Care)
Biopsy

Keywords

  • Biochemical failure
  • Brachytherapy
  • External beam radiation therapy
  • Predictive factors
  • Prostate cancer
  • Risk group

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

Biochemical outcomes and predictive factors by risk group after permanent iodine-125 seed implantation : Prospective cohort study in 2,316 patients. / Katayama, Norihisa; Nakamura, Katsumasa; Yorozu, Atsunori; Kikuchi, Takashi; Fukushima, Masanori; Saito, Shiro; Dokiya, Takushi.

In: Brachytherapy, 01.01.2019.

Research output: Contribution to journalArticle

Katayama, Norihisa ; Nakamura, Katsumasa ; Yorozu, Atsunori ; Kikuchi, Takashi ; Fukushima, Masanori ; Saito, Shiro ; Dokiya, Takushi. / Biochemical outcomes and predictive factors by risk group after permanent iodine-125 seed implantation : Prospective cohort study in 2,316 patients. In: Brachytherapy. 2019.
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abstract = "Purpose: To evaluate the biochemical freedom from failure (bFFF)by risk group and treatment modality and the predictive factors of bFFF by risk group in patients with prostate cancer undergoing permanent seed implantation (PI)with or without external beam radiation therapy (EBRT)in a nationwide prospective cohort study (Japanese Prostate Cancer Outcome Study of Permanent Iodine-125 [I-125]Seed Implantation)in Japan during the first 2 years. Methods and Materials: The analyses included 2,316 participants in 42 institutions; bFFF was evaluated using the Phoenix definition and calculated using the Kaplan–Meier method, and the Cox proportional hazards model was used to identify the factors associated with bFFF. Results: Median followup period was 60.0 months. The 5-year bFFF rates in all patients, 1,028 low-risk patients, 1,114 intermediate-risk patients, and 133 high-risk patients were 93.6{\%}, 94.9{\%}, 92.7{\%}, and 91.1{\%}, respectively. The 5-year bFFF rates in the PI group and EBRT combination therapy group were 93.7{\%} and 93.3{\%}, respectively. In a multivariate analysis, younger age, higher Gleason score (GS), higher percent positive biopsies ({\%}PB), and lower prostate V100 (p = 0.0012, 0.0030, 0.0026, and 0.0368)in all patients; younger age, higher pretreatment prostate-specific antigen, and lower prostate V100 (p = 0.0002, 0.0048, and 0.0012)in low-risk patients; higher GS, higher {\%}PB, and no hormonal treatment (p = 0.0005, 0.0120, and 0.0022)in intermediate-risk patients; and higher GS and higher {\%}PB (p = 0.0329 and 0.0120)in high-risk patients were significantly associated with bFFF. Conclusions: PI with or without EBRT resulted in excellent short-term biochemical outcomes in all risk groups, especially in high-risk patients. Age, pretreatment prostate-specific antigen, and prostate V100 in low-risk patients; GS, {\%}PB, and hormonal treatment in intermediate-risk patients; and GS and {\%}PB in high-risk patients were independently affected bFFF.",
keywords = "Biochemical failure, Brachytherapy, External beam radiation therapy, Predictive factors, Prostate cancer, Risk group",
author = "Norihisa Katayama and Katsumasa Nakamura and Atsunori Yorozu and Takashi Kikuchi and Masanori Fukushima and Shiro Saito and Takushi Dokiya",
year = "2019",
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T1 - Biochemical outcomes and predictive factors by risk group after permanent iodine-125 seed implantation

T2 - Prospective cohort study in 2,316 patients

AU - Katayama, Norihisa

AU - Nakamura, Katsumasa

AU - Yorozu, Atsunori

AU - Kikuchi, Takashi

AU - Fukushima, Masanori

AU - Saito, Shiro

AU - Dokiya, Takushi

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Purpose: To evaluate the biochemical freedom from failure (bFFF)by risk group and treatment modality and the predictive factors of bFFF by risk group in patients with prostate cancer undergoing permanent seed implantation (PI)with or without external beam radiation therapy (EBRT)in a nationwide prospective cohort study (Japanese Prostate Cancer Outcome Study of Permanent Iodine-125 [I-125]Seed Implantation)in Japan during the first 2 years. Methods and Materials: The analyses included 2,316 participants in 42 institutions; bFFF was evaluated using the Phoenix definition and calculated using the Kaplan–Meier method, and the Cox proportional hazards model was used to identify the factors associated with bFFF. Results: Median followup period was 60.0 months. The 5-year bFFF rates in all patients, 1,028 low-risk patients, 1,114 intermediate-risk patients, and 133 high-risk patients were 93.6%, 94.9%, 92.7%, and 91.1%, respectively. The 5-year bFFF rates in the PI group and EBRT combination therapy group were 93.7% and 93.3%, respectively. In a multivariate analysis, younger age, higher Gleason score (GS), higher percent positive biopsies (%PB), and lower prostate V100 (p = 0.0012, 0.0030, 0.0026, and 0.0368)in all patients; younger age, higher pretreatment prostate-specific antigen, and lower prostate V100 (p = 0.0002, 0.0048, and 0.0012)in low-risk patients; higher GS, higher %PB, and no hormonal treatment (p = 0.0005, 0.0120, and 0.0022)in intermediate-risk patients; and higher GS and higher %PB (p = 0.0329 and 0.0120)in high-risk patients were significantly associated with bFFF. Conclusions: PI with or without EBRT resulted in excellent short-term biochemical outcomes in all risk groups, especially in high-risk patients. Age, pretreatment prostate-specific antigen, and prostate V100 in low-risk patients; GS, %PB, and hormonal treatment in intermediate-risk patients; and GS and %PB in high-risk patients were independently affected bFFF.

AB - Purpose: To evaluate the biochemical freedom from failure (bFFF)by risk group and treatment modality and the predictive factors of bFFF by risk group in patients with prostate cancer undergoing permanent seed implantation (PI)with or without external beam radiation therapy (EBRT)in a nationwide prospective cohort study (Japanese Prostate Cancer Outcome Study of Permanent Iodine-125 [I-125]Seed Implantation)in Japan during the first 2 years. Methods and Materials: The analyses included 2,316 participants in 42 institutions; bFFF was evaluated using the Phoenix definition and calculated using the Kaplan–Meier method, and the Cox proportional hazards model was used to identify the factors associated with bFFF. Results: Median followup period was 60.0 months. The 5-year bFFF rates in all patients, 1,028 low-risk patients, 1,114 intermediate-risk patients, and 133 high-risk patients were 93.6%, 94.9%, 92.7%, and 91.1%, respectively. The 5-year bFFF rates in the PI group and EBRT combination therapy group were 93.7% and 93.3%, respectively. In a multivariate analysis, younger age, higher Gleason score (GS), higher percent positive biopsies (%PB), and lower prostate V100 (p = 0.0012, 0.0030, 0.0026, and 0.0368)in all patients; younger age, higher pretreatment prostate-specific antigen, and lower prostate V100 (p = 0.0002, 0.0048, and 0.0012)in low-risk patients; higher GS, higher %PB, and no hormonal treatment (p = 0.0005, 0.0120, and 0.0022)in intermediate-risk patients; and higher GS and higher %PB (p = 0.0329 and 0.0120)in high-risk patients were significantly associated with bFFF. Conclusions: PI with or without EBRT resulted in excellent short-term biochemical outcomes in all risk groups, especially in high-risk patients. Age, pretreatment prostate-specific antigen, and prostate V100 in low-risk patients; GS, %PB, and hormonal treatment in intermediate-risk patients; and GS and %PB in high-risk patients were independently affected bFFF.

KW - Biochemical failure

KW - Brachytherapy

KW - External beam radiation therapy

KW - Predictive factors

KW - Prostate cancer

KW - Risk group

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