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cover_jumps_1209.qxp 11/24/09 12:03 PM Page 3 www.renalandurologynews.com DECEMBER 2009 Renal & Urology News 9 High Hb continued from page 1 out heart failure, however, had an 86% Time to Biochemical Failure Matters increased risk. After radiotherapy, earlier PSA relapse predicts a higher PCa death risk Similarly, patients with diabetes mellitus did not have an increased BY JOHN SCHIESZER risk associated with higher Hb tar- CHICAGO—The interval between gets. While patients without diabetes radiation treatment for prostate can- mellitus did have an increased risk cer and biochemical failure may associated with the higher goal, the predict the likelihood of death from © HEALTH PROTECTION AGENCY / PHOTO RESEARCHERS, INC. interaction between diabetes and the malignancy, researchers reported treatment arm, did not reach conven- here at the American Society for tional levels of statistical significant in Radiation Oncology annual meeting. multivariable analyses. In a study, 48% of patients who Dr. Szczech and her group also died from prostate cancer following examined the interaction between radiotherapy experienced biochem- diabetes and heart failure and hemo- ical failure within the first 18 months globin goal. Patients without a his- compared with only 14% of pa- tory of either prior heart failure or tients who did not die from prostate diabetes had a twofold increased risk cancer, said lead investigator Mark associated with the higher Hb goal. Buyyounouski, MD, Director of Clin- In a study, 19% of radiotherapy patients had a PSA relapse in 18 months or less. Patients with diabetes but no history ical Research at Fox Chase Cancer of heart failure had a 75% increased Center in Philadelphia. prostate cancer who had biochemical sooner means a patient has a greater risk associated with the higher goal, Clinicians should consider using failure after treatment. A total of 338 danger of dying of prostate cancer.” and subjects with prior heart failure the 18-month time point when evalu- men died from prostate cancer. The In a prior study, Dr. Buyyounouski with or without diabetes were not at ating patients and counseling them median interval between treatment and his colleagues showed that men increased risk. about their risk of death and sal- and biochemical failure was 35.2 who experienced early biochemical vage therapy after biochemical fail- months for the entire study group. failure had the highest risk of dying ure, Dr. Buyyounuski said. Biochemical failure occurred in 19% from prostate cancer. The new study Patients with “If a patient has biochemical failure of patients in 18 months or less. The confirms those results using a multi- heart failure and at 16 months, rather than wait and five-year cancer-specific survival was national database and shows that the learn later that the PSA is rising 69.5% for these men compared with measure is ready for use in the clinic. diabetes differ sharply and that there is risk for the 89.8% for men whose biochemical “Now, we can use the simple criteria development of distant metastasis, failure occurred after 18 months. from this study, which is widely avail- from “all comers.” [salvage] therapy can be started “PSA is the gold standard for fol- able for anyone who has PSA testing, sooner based on the increased risk of lowing prostate cancer patients after to identify men who have a greater “It is unclear whether the mecha- death,” he said. they receive radiation or surgery,” than 25% chance of dying from pros- nism for this differential treatment He and his colleagues studied of Dr. Buyyounouski said. “But we tate cancer in the next five years. That effect might be due to the stronger 2,132 men with clinically localized
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