| Title |
Intermediate Endpoints After Postprostatectomy Radiotherapy: 5-Year Distant Metastasis to Predict Overall Survival
|
|---|---|
| Published in |
European Urology, January 2018
|
| DOI | 10.1016/j.eururo.2017.12.023 |
| Pubmed ID | |
| Authors |
William C. Jackson, Krithika Suresh, Vasu Tumati, Steven G. Allen, Robert T. Dess, Simpa S. Salami, Arvin George, Samuel D. Kaffenberger, David C. Miller, Jason W.D. Hearn, Shruti Jolly, Rohit Mehra, Brent K. Hollenbeck, Ganesh S. Palapattu, Matthew Schipper, Felix Y. Feng, Todd M. Morgan, Neil B. Desai, Daniel E. Spratt |
| Abstract |
Intermediate clinical endpoints (ICEs) prognostic for overall survival (OS) are needed for men receiving postprostatectomy radiation therapy (PORT) to improve clinical trial design. To identify a potential ICE for men receiving PORT. We performed an institutional review board-approved multi-institutional retrospective study of 566 men consecutively treated with PORT at tertiary care centers from 1986 to 2013. The median follow-up was 8.2 yr. Biochemical failure (BF), distant metastases (DM), and castrate-resistant prostate cancer (CRPC) were evaluated for correlation with OS and assessed as time-dependent variables in a multivariable Cox proportional hazards model and in landmark analyses at 1, 3, 5, and 7 yr after PORT. Cross-validated concordance (c) indices were used to assess model discrimination. OS at 1, 3, 5, and 7 yr after PORT was 98%, 95%, 90%, and 82%, respectively. In a time-varying model controlling for clinical and pathologic variables, BF (hazard ratio [HR] 2.32, 95% confidence interval [CI] 1.45-3.71; p<0.001), DM (HR 6.52, 95% CI 4.20-10.1; p<0.001), and CRPC (HR 2.47, 95% CI 1.56-3.92; p<0.001) were associated with OS. In landmark analyses, 5-yr DM had the highest c index when adjusting for baseline covariates (0.78), with 5-yr DM also providing the greatest increase in discriminatory power over a model only including baseline covariates. These findings require validation in prospective randomized data. While limited by the retrospective nature of the data, 5-yr DM is associated with lower OS following PORT, outperforming the prognostic capability of BF and CRPC at 1, 3, 5, or 7 yr after treatment. Confirmation of this ICE as a surrogate for OS is needed from randomized trial data so that it can be incorporated into future clinical trial design. We assessed potential intermediate clinical endpoints prognostic for overall survival in a cohort of men receiving radiotherapy after prostatectomy. We identified the development of metastatic disease within 5 yr after treatment as the strongest predictor of overall survival. |
X Demographics
The data shown below were collected from the profiles of 55 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 16 | 29% |
| Spain | 5 | 9% |
| Australia | 2 | 4% |
| Canada | 2 | 4% |
| United Kingdom | 2 | 4% |
| Ecuador | 1 | 2% |
| Netherlands | 1 | 2% |
| Germany | 1 | 2% |
| Pakistan | 1 | 2% |
| Other | 8 | 15% |
| Unknown | 16 | 29% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 27 | 49% |
| Scientists | 15 | 27% |
| Practitioners (doctors, other healthcare professionals) | 8 | 15% |
| Science communicators (journalists, bloggers, editors) | 5 | 9% |
Mendeley readers
The data shown below were compiled from readership statistics for 59 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 59 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Unspecified | 10 | 17% |
| Student > Master | 9 | 15% |
| Student > Ph. D. Student | 7 | 12% |
| Student > Bachelor | 6 | 10% |
| Researcher | 6 | 10% |
| Other | 8 | 14% |
| Unknown | 13 | 22% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 21 | 36% |
| Unspecified | 10 | 17% |
| Economics, Econometrics and Finance | 2 | 3% |
| Agricultural and Biological Sciences | 2 | 3% |
| Biochemistry, Genetics and Molecular Biology | 1 | 2% |
| Other | 7 | 12% |
| Unknown | 16 | 27% |
Attention Score in Context
This research output has an Altmetric Attention Score of 32. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 03 October 2018.
All research outputs
#1,235,169
of 25,382,440 outputs
Outputs from European Urology
#748
of 6,218 outputs
Outputs of similar age
#28,225
of 450,297 outputs
Outputs of similar age from European Urology
#26
of 95 outputs
Altmetric has tracked 25,382,440 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 95th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 6,218 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 16.1. This one has done well, scoring higher than 87% of its peers.
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We're also able to compare this research output to 95 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 72% of its contemporaries.