BACKGROUND: Recent large, prospective, randomised studies have demonstrated that adjuvant radiotherapy (RT) is a safe and effective procedure for preventing disease recurrence in locally advanced prostate cancer (PCa) patients. However, no study has ever tested the role of adjuvant RT in node-positive patients after radical prostatectomy (RP). OBJECTIVE: We hypothesised that adjuvant RT with early hormone therapy (HT) might improve long-term outcomes of patients with PCa and nodal metastases treated with RP and extended pelvic lymph node dissection (ePLND). DESIGN, SETTING, AND PARTICIPANTS: This retrospective study included 250 consecutive patients with pathologic lymph node invasion. We assessed factors predicting long-term biochemical recurrence (BCR)-free and cancer-specific survival (CSS) in node-positive PCa patients treated with RP, ePLND, and adjuvant treatments between 1988 and 2002 in a tertiary academic centre. INTERVENTION: All patients received adjuvant treatments according to the treating physician after detailed patient information: 129 patients (51.6%) were treated with a combination of RT and HT, while 121 patients (48.4%) received adjuvant HT alone. MEASUREMENTS: BCR-free survival and CSS in patients with node-positive PCa. RESULTS AND LIMITATIONS: Mean follow-up was 95.9 mo (median: 91.2). BCR-free survival and CSS rates at 5, 8, and 10 yr were 72%, 61%, 53% and 89%, 83%, 80%, respectively. In multivariable Cox regression models, adjuvant RT and the number of positive nodes were independent predictors of BCR-free survival (p=0.002 and p=0.003, respectively) as well as of CSS (p=0.009 and p=0.01, respectively). Moreover, there was significant gain in predictive accuracy when adjuvant RT was included in multivariable models predicting BCR-free survival and CSS (gain: 3.3% and 3%, respectively; all p<0.001). CONCLUSIONS: Our data showed excellent long-term outcome for node-positive PCa patients treated with radical surgery plus adjuvant treatments. This study is the first to report a significant protective role for adjuvant RT in BCR-free survival and CSS of node-positive patients.
BACKGROUND: Recent large, prospective, randomised studies have demonstrated that adjuvant radiotherapy (RT) is a safe and effective procedure for preventing disease recurrence in locally advanced prostate cancer (PCa) patients. However, no study has ever tested the role of adjuvant RT in node-positive patients after radical prostatectomy (RP). OBJECTIVE: We hypothesised that adjuvant RT with early hormone therapy (HT) might improve long-term outcomes of patients with PCa and nodal metastases treated with RP and extended pelvic lymph node dissection (ePLND). DESIGN, SETTING, AND PARTICIPANTS: This retrospective study included 250 consecutive patients with pathologic lymph node invasion. We assessed factors predicting long-term biochemical recurrence (BCR)-free and cancer-specific survival (CSS) in node-positive PCa patients treated with RP, ePLND, and adjuvant treatments between 1988 and 2002 in a tertiary academic centre. INTERVENTION: All patients received adjuvant treatments according to the treating physician after detailed patient information: 129 patients (51.6%) were treated with a combination of RT and HT, while 121 patients (48.4%) received adjuvant HT alone. MEASUREMENTS: BCR-free survival and CSS in patients with node-positive PCa. RESULTS AND LIMITATIONS: Mean follow-up was 95.9 mo (median: 91.2). BCR-free survival and CSS rates at 5, 8, and 10 yr were 72%, 61%, 53% and 89%, 83%, 80%, respectively. In multivariable Cox regression models, adjuvant RT and the number of positive nodes were independent predictors of BCR-free survival (p=0.002 and p=0.003, respectively) as well as of CSS (p=0.009 and p=0.01, respectively). Moreover, there was significant gain in predictive accuracy when adjuvant RT was included in multivariable models predicting BCR-free survival and CSS (gain: 3.3% and 3%, respectively; all p<0.001). CONCLUSIONS: Our data showed excellent long-term outcome for node-positive PCa patients treated with radical surgery plus adjuvant treatments. This study is the first to report a significant protective role for adjuvant RT in BCR-free survival and CSS of node-positive patients.
Authors: A-C Müller; J Lütjens; M Alber; F Eckert; M Bamberg; D Schilling; C Belka; U Ganswindt Journal: Strahlenther Onkol Date: 2012-10-11 Impact factor: 3.621
Authors: Philipp Mandel; Clemens Rosenbaum; Raisa S Pompe; Thomas Steuber; Georg Salomon; Felix K Chun; Markus Graefen; Hartwig Huland; Derya Tilki Journal: World J Urol Date: 2017-08-21 Impact factor: 4.226
Authors: Gilles Créhange; Chien Peter Chen; Charles C Hsu; Norbert Kased; Fergus V Coakley; John Kurhanewicz; Mack Roach Journal: Cancer Treat Rev Date: 2012-06-15 Impact factor: 12.111
Authors: Filip Poelaert; Valérie Fonteyne; Piet Ost; Bart De Troyer; Karel Decaestecker; Gert De Meerleer; Pieter De Visschere; Tom Claeys; Bert Dhondt; Nicolaas Lumen Journal: Strahlenther Onkol Date: 2017-01-18 Impact factor: 3.621
Authors: Jarrod B Adkison; Derek R McHaffie; Søren M Bentzen; Rakesh R Patel; Deepak Khuntia; Daniel G Petereit; Theodore S Hong; Wolfgang Tomé; Mark A Ritter Journal: Int J Radiat Oncol Biol Phys Date: 2010-12-14 Impact factor: 7.038
Authors: Karim A Touijer; Robert Jeffery Karnes; Niccolo Passoni; Daniel D Sjoberg; Melissa Assel; Nicola Fossati; Giorgio Gandaglia; James A Eastham; Peter T Scardino; Andrew Vickers; Cesare Cozzarini; Francesco Montorsi; Alberto Briganti Journal: Eur Urol Date: 2017-10-16 Impact factor: 20.096