- In patients with high-grade localized prostate cancer undergoing radiotherapy, local failure showed independent association with OS, prostate cancer-specific survival (PCSS), and distant metastasis-free survival (DMFS).
- Local failure before distant metastasis was associated with lower PCSS.
Why this matters
- Local failure in these patients warrants upfront treatment intensification.
- A meta-analysis of 6 randomized studies involving 992 patients with high-grade localized prostate cancer.
- Funding: None.
- Median follow-up was 6.4 years.
- Local failure was associated with worse OS (HR, 1.70; P<.001 pcss p and dmfs>
- In patients who received radiotherapy+short-term androgen therapy and experienced distant metastasis, the median time to event was significantly longer in those who had local failure vs those who had not (4.58 vs 2.38 years; P<.01>
- Patients who had not transitioned to the local failure vs those who transitioned to the local failure state before distant metastasis had a significantly higher PCSS (HR, 0.14; P<.001>
- Patients who transitioned to the local failure state showed an increased risk for distant metastasis or death (HR, 1.86; P=.04) vs those who did not.
- Heterogeneity across studies.