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(Tollefson et al. 2007)
Design: Retrospective case series (prognosis), evidence level: 3
Country: United States, setting: Tertiary care
Inclusion criteria Men treated with radical prostatectomy for prostate cancer at a single institution (1990 to 1999), who then experienced biochemical failure (PSA or 0.4 ng/mL or higher).
Exclusion criteria Neoadjuvant therapy.
Population number of patients = 1521.
Interventions All men initially had radical retropubic prostatectomy (RRP). A proportion of the men were treated with radiotherapy (28%) and or hormonal therapy (34%) after biochemical failure.
Outcomes Local recurrence (identified using TRUS, DRE, MRI or biopsy) and systemic recurrence (metastatic disease on bone scan).
Follow up PSA-DT data were available for 1064/1521 men (70%).
Results Of the 1064 men with PSA-DT data, 322 (30%) had a PSA-DT of less than 1 year, 357 (34%) had a PSA-DT of 1 to 9.9 years, and 385 (36%) had a PSA-DT of 10 years or more.
Men with a PSA-DT of 10 years or more were at lower risk of local recurrence (hazard ratio [HR], 0.09; 95% confidence interval [CI], 0.06–0.14; compared with men with a PSA-DT of <1 year), systemic progression (HR, 0.05; 95% CI, 0.02–0.13), or death from prostate cancer (HR, 0.15; 95% CI, 0.05–0.43).

From: Chapter 5 –The Management of Relapse After Radical Treatment

Cover of Prostate Cancer
Prostate Cancer: Diagnosis and Treatment.
NICE Clinical Guidelines, No. 58.
National Collaborating Centre for Cancer (UK).
Copyright © 2008, National Collaborating Centre for Cancer.

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