A multi-institutional matched-control analysis of adjuvant and salvage postoperative radiation therapy for pT3-4N0 prostate cancer Journal Article
| Authors: | Trabulsi, E. J.; Valicenti, R. K.; Hanlon, A. L.; Pisansky, T. M.; Sandler, H. M.; Kuban, D. A.; Catton, C. N.; Michalski, J. M.; Zelefsky, M. J.; Kupelian, P. A.; Lin, D. W.; Anscher, M. S.; Slawin, K. M.; Roehrborn, C. G.; Forman, J. D.; Liauw, S. L.; Kestin, L. L.; DeWeese, T. L.; Scardino, P. T.; Stephenson, A. J.; Pollack, A. |
| Article Title: | A multi-institutional matched-control analysis of adjuvant and salvage postoperative radiation therapy for pT3-4N0 prostate cancer |
| Abstract: | Objectives: It is unclear whether postoperative salvage radiation therapy (SRT) and early adjuvant radiotherapy (ART) after radical prostatectomy lead to equivalent long-term tumor control. We studied a group of patients undergoing ART by comparing them with a matched control group undergoing SRT after biochemical failure. Methods: Using a multi-institutional database of 2299 patients, 449 patients with pT3-4N0 disease were eligible for inclusion, including 211 patients receiving ART and 238 patients receiving SRT. Patients were matched in a 1:1 ratio according to preoperative prostate-specific antigen Gleason score, seminal vesicle invasion, surgical margin status, and follow-up from date of surgery. Results: A total of 192 patients were matched (96:96). The median follow-up was 94 months from surgery and 73 months from RT completion. There was a significant reduction in biochemical failure with ART compared with SRT. The 5-year freedom from biochemical failure (FFBF) from surgery was 75% after ART, compared with 66% for SRT (hazard ratio [HR] = 1.6, P = .049). The 5-year FFBF from the end of RT was 73% after ART, compared with 50% after SRT (HR = 2.3, log rank [LR] P = .0007). From the end of RT, SRT and Gleason score ≥8 were independent predictors of diminished FFBF. From the date of surgery, Gleason score ≥8 was a significant predictor of FFBF. Conclusions: Early ART for pT3-4N0 prostate cancer significantly reduces the risk of long-term biochemical progression after radical prostatectomy compared with SRT. Gleason score ≥8 was the only factor on multivariate analysis associated with metastasic progression. © 2008 Elsevier Inc. All rights reserved. |
| Keywords: | controlled study; treatment outcome; major clinical study; case-control studies; postoperative period; salvage therapy; adjuvant therapy; cancer radiotherapy; postoperative care; follow up; prostate specific antigen; proportional hazards models; radiotherapy; data base; time factors; prostate cancer; gleason score; prostatic neoplasms; preoperative period; prostatectomy; multivariate analysis; seminal vesicle |
| Journal Title: | Urology |
| Volume: | 72 |
| Issue: | 6 |
| ISSN: | 0090-4295 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2008-12-01 |
| Start Page: | 1298 |
| End Page: | 1302 |
| Language: | English |
| DOI: | 10.1016/j.urology.2008.05.057 |
| PUBMED: | 18672274 |
| PROVIDER: | scopus |
| PMCID: | PMC4020432 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 20" - "Export Date: 17 November 2011" - "CODEN: URGYA" - "Source: Scopus" |
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