Evidence map›Paper›PMID 31718822›Full record

SynthesisEuropean urology2020

Local Failure and Survival After Definitive Radiotherapy for Aggressive Prostate Cancer: An Individual Patient-level Meta-analysis of Six Randomized Trials.

Amar U Kishan, Fang-I Chu, Christopher R King, Wendy Seiferheld, Daniel E Spratt, Phuoc Tran, Xiaoyan Wang, Stephanie E Pugh, Kiri A Sandler, Michel Bolla and 17 more

Open access · greenAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in European urology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 4 pooled it
5.2field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 4 syntheses or guidelines pooled it, 58 citations in OpenAlex.

  1. Pooled it
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  11. No disease left behind.Oncotarget · 2025
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

27 authors at 12 institutions in 4 countries.

Amar U KishanDepartment of Radiation Oncology, University of California, Los Angeles, CA, USA; Department of Urology, University of California, Los Angeles, CA, USA. Electronic address: aukishan@mednet.ucla.edu.
Fang-I ChuDepartment of Radiation Oncology, University of California, Los Angeles, CA, USA.
Christopher R KingDepartment of Radiation Oncology, University of California, Los Angeles, CA, USA.
Wendy SeiferheldNRG Oncology Statistics and Data Management Center, Philadelphia, PA, USA.
Daniel E SprattDepartment of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA.
Phuoc TranDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Xiaoyan WangDepartment of General Internal Medicine and Health Services Research, University of California, Los Angeles, CA, USA.
Stephanie E PughNRG Oncology Statistics and Data Management Center, Philadelphia, PA, USA.
Kiri A SandlerDepartment of Radiation Oncology, University of California, Los Angeles, CA, USA.
Michel BollaDepartment of Radiation Oncology, Centre Hospitalier Universitaire de Grenoble, Grenoble, France.
Philippe MaingonCentre Georges-François Leclerc, Dijon, France; Sorbonne Université Paris, Paris, France.
Theo De ReijkeDepartment of Urology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.
Nicholas G NickolsDepartment of Radiation Oncology, University of California, Los Angeles, CA, USA; Department of Radiation Oncology, Veteran Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
Matthew RettigDivision of Hematology and Oncology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA; Division of Hematology and Oncology, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
Alexandra DrakakiDivision of Hematology and Oncology, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
Sandy T LiuDivision of Hematology and Oncology, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
Robert E ReiterDepartment of Urology, University of California, Los Angeles, CA, USA.
Albert J ChangDepartment of Radiation Oncology, University of California, Los Angeles, CA, USA.
Felix Y FengDepartments of Radiation Oncology, Urology, and Medicine, University of California, San Francisco, CA, USA.
Dipti SajedDepartment of Pathology, University of California, Los Angeles, CA, USA.
Paul L NguyenDepartment of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
Patrick A KupelianDepartment of Radiation Oncology, University of California, Los Angeles, CA, USA.
Michael L SteinbergDepartment of Radiation Oncology, University of California, Los Angeles, CA, USA.
Paul C BoutrosDepartment of Urology, University of California, Los Angeles, CA, USA; Department of Human Genetics, University of California, Los Angeles, CA, USA.
David ElashoffDepartment of General Internal Medicine and Health Services Research, University of California, Los Angeles, CA, USA.
Laurence ColletteEuropean Organization for Research and Treatment of Cancer Headquarters, Brussels, Belgium.
Howard M SandlerDepartment of Radiation Oncology, Cedars Sinai, Los Angeles, CA, USA.
University of California, Los Angeles · USNRG Oncology · USVA Greater Los Angeles Healthcare System · USAmsterdam University Medical Centers · NLBrigham and Women's Hospital · USCedars-Sinai Medical Center · USCentre Hospitalier Universitaire de Grenoble · FREuropean Organisation for Research and Treatment of Cancer · BEJohns Hopkins University · USUniversité Sorbonne Nouvelle · FRUniversity of California, San Francisco · USUniversity of Michigan · US

Funding

NRG Oncology Network Group Operations Center - GY9 BIQSFP Reports/BudgetsU10CA180868 · NCI · NRG ONCOLOGY FOUNDATION, INC. · PI NORMAN WOLMARK · 2014 to 2026
$206.8M
Statistics CoreU10CA180822 · NCI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI James J. Dignam, GREG YOTHERS · 2014 to 2026
$146.4M
Women's CancersP30CA016042 · NCI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Samuel Wheeler French · 1985 to 2026
$134.5M
UCLA SPORE IN PROSTATE CANCERP50CA092131 · NCI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI REITER, ROBERT E · 2002 to 2023
$42.6M
NCI NIH HHS P30 CA016042NCI NIH HHS P50 CA092131NCI NIH HHS U10 CA180822NCI NIH HHS U10 CA180868
6 · The paper itself

Abstract

backgroundThe importance of local failure (LF) after treatment of high-grade prostate cancer (PCa) with definitive radiotherapy (RT) remains unknown.

objectiveTo evaluate the clinical implications of LF after definitive RT. DESIGN, SETTING, AND

participantsIndividual patient data meta-analysis of 992 patients (593 Gleason grade group [GG] 4 and 399 GG 5) enrolled in six randomized clinical trials. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Multivariable Cox proportional hazard models were developed to evaluate the relationship between overall survival (OS), PCa-specific survival (PCSS), and distant metastasis (DM)-free survival (DMFS) and LF as a time-dependent covariate. Markov proportional hazard models were developed to evaluate the impact of specific transitions between disease states on these endpoints. RESULTS AND LIMITATIONS: Median follow-up was 6.4 yr overall and 7.2 yr for surviving patients. LF was significantly associated with OS (hazard ratio [HR] 1.70 [95% confidence interval {CI} 1.37-2.10]), PCSS (3.10 [95% CI 2.33-4.12]), and DMFS (HR 1.92 [95% CI 1.54-2.39]), p < 0.001 for all). Patients who had not transitioned to the LF state had a significantly lower hazard of transitioning to a PCa-specific death state than those who transitioned to the LF state (HR 0.13 [95% CI 0.04-0.41], p < 0.001). Additionally, patients who transitioned to the LF state had a greater hazard of DM or death (HR 2.46 [95% CI 1.22-4.93], p = 0.01) than those who did not.

conclusionsLF is an independent prognosticator of OS, PCSS, and DMFS in high-grade localized PCa and a subset of DM events that are anteceded by LF events. LF events warrant consideration for intervention, potentially suggesting a rationale for upfront treatment intensification. However, whether these findings apply to all men or just those without significant comorbidity remains to be determined. PATIENT SUMMARY: Men who experience a local recurrence of high-grade prostate cancer after receiving upfront radiation therapy are at significantly increased risks of developing metastases and dying of prostate cancer.

Indexed as

HumansMaleNeoplasm GradingProstatic NeoplasmsRandomized Controlled Trials as TopicTreatment FailureHigh gradeLocal failureRadiotherapy

Identifiers

PMID31718822
PMCPMC7008470
OpenAlexW2987877358

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.