Shauna Campbell, MD of Cleveland Clinic explains the impact of post-prostatectomy prostate specific antigen (PSA) kinetics on outcomes of salvage radiotherapy.
The integration of prostate-specific antigen (PSA) kinetics into a nomogram widely used to predict outcomes of salvage therapy offers physicians and patients a more nuanced, longer-term look at prostate cancer-specific outcomes.
In 2007, a multi-institutional cohort led by Cleveland Clinic’s Glickman Urological and Kidney Institute developed a nomogram to predict prostate cancer-specific and all-cause mortality at six years after salvage radiotherapy (SRT).
Almost a decade later, a study led by Cleveland Clinic Cancer Center radiation oncologist Rahul D. Tendulkar, MD, updated the nomogram with evidence that early initiation of SRT following radical prostatectomy (RP) reduced biochemical failure (BF) and distant metastases (DM).
The researchers’ most recent update to the nomogram was presented at the 2019 annual meeting of the American Society for Radiation Oncology (ASTRO).
“One critique of our previous update was the lack of PSA kinetics among the predictive factors,” says Shauna Campbell, DO, chief resident, radiation oncology, Cleveland Clinic. “This version of the nomogram adds initial postoperative PSA level and PSA doubling time [PSADT] to the picture.”