TY - JOUR
T1 - The influence of local control on metastatic dissemination of prostate cancer treated by external beam megavoltage radiation therapy
AU - Zagars, Gunar K.
AU - Von Eschenbach, Andrew C.
AU - Ayala, Alberto G.
AU - Schultheiss, Timothy E.
AU - Sherman, Neil E.
N1 - Copyright:
Copyright 2016 Elsevier B.V., All rights reserved.
PY - 1991/12/1
Y1 - 1991/12/1
N2 - The influence of local control on metastatic dissemination was analyzed in 601 patients with clinically staged A2 to C prostate cancer treated by high- energy external beam radiation therapy who did not undergo hormonal manipulation before disease progression. Median follow-up for surviving patients was 7.7 years. Ninety-three patients had locally recurrent disease. The actuarial incidence of metastases in these patients (70% at 13 years) was significantly higher than in the 508 patients without local failure (40% at 13 years, P < 0.001). High stage, high grade, prior transurethral resection, elevated acid phosphatase, disease fixation to the pelvic sidewall, and failure to perform a baseline bone scan correlated positively with the occurrence of metastases. However, except for a slight excess of Stage C, none of the metastatic predictors were more common in patients who failed locally than in those who did not. The Stage C preponderance does not account for the difference in incidence of metastases between the two groups, in as much as metastases were significantly more common in Stage C when disease recurred locally than when it did not. Thus, local control of prostate cancer does decrease the likelihood of metastatic disease. Moreover, patients with local control experienced a significantly better disease-specific survival than patients who failed locally.
AB - The influence of local control on metastatic dissemination was analyzed in 601 patients with clinically staged A2 to C prostate cancer treated by high- energy external beam radiation therapy who did not undergo hormonal manipulation before disease progression. Median follow-up for surviving patients was 7.7 years. Ninety-three patients had locally recurrent disease. The actuarial incidence of metastases in these patients (70% at 13 years) was significantly higher than in the 508 patients without local failure (40% at 13 years, P < 0.001). High stage, high grade, prior transurethral resection, elevated acid phosphatase, disease fixation to the pelvic sidewall, and failure to perform a baseline bone scan correlated positively with the occurrence of metastases. However, except for a slight excess of Stage C, none of the metastatic predictors were more common in patients who failed locally than in those who did not. The Stage C preponderance does not account for the difference in incidence of metastases between the two groups, in as much as metastases were significantly more common in Stage C when disease recurred locally than when it did not. Thus, local control of prostate cancer does decrease the likelihood of metastatic disease. Moreover, patients with local control experienced a significantly better disease-specific survival than patients who failed locally.
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U2 - 10.1002/1097-0142(19911201)68:11<2370::AID-CNCR2820681107>3.0.CO;2-T
DO - 10.1002/1097-0142(19911201)68:11<2370::AID-CNCR2820681107>3.0.CO;2-T
M3 - Article
C2 - 1933773
AN - SCOPUS:0026337286
SN - 0008-543X
VL - 68
SP - 2370
EP - 2377
JO - Cancer
JF - Cancer
IS - 11
ER -