In prostate cancer, robotic total prostatectomy is a popular treatment modality. However, prostate-specific antigen (PSA) recurrence after prostate cancer surgery remains a concern. Salvage radiotherapy is commonly used to treat PSA recurrence, but the recurrence rate after salvage radiotherapy is high, highlighting the need for better predictive markers. This study aimed to retrospectively evaluate the association between cribriform pattern and PSA recurrence in patients receiving radiotherapy after radical prostatectomy.
Data of 50 patients who underwent radiotherapy after total prostatectomy between January 2010 and May 2020 were retrospectively evaluated. The median age was 67 years. Among these patients, two cases involved postoperative irradiation, while 48 cases involved salvage irradiation after postoperative PSA recurrence. The median time from surgery to PSA recurrence was 38.3 months. The median radiation dose was 64 Gy in 32 fractions. Three-dimensional conformal radiation therapy was administered in 38 cases and intensity-modulated radiation therapy was used in 12 cases. Combined hormone therapy was administered in 21 cases. PSA levels were measured every 3 months after treatment. Statistical analysis between groups was performed by a t-test.
The median follow-up period after radiotherapy was 31 months. No local recurrences were observed at the prostate bed, and no deaths related to prostate cancer were recorded during follow-up. However, 18 patients (36.0%) had PSA recurrence. The PSA recurrence rate based on the cribriform pattern was 17.6% in the none to moderate group (34 patients) and 75.0% in the severe cribriform pattern group (16 patients). The PSA recurrence rate was significantly higher in patients with a severe invasive cribriform pattern (p=0.001). No significant differences were observed in other histopathological characteristics.
The cribriform pattern in surgical pathology specimens was found to be a useful predictor of PSA recurrence after postoperative radiotherapy.
Cancer diagnosis & prognosis. 2024 Nov 03*** epublish ***
Masahiro Kawahara, Akira Tanaka, Keiko Akahane, Masashi Endo, Yukiko Fukuda, Kohei Okada, Kazunari Ogawa, Satoru Takahashi, Michiko Nakamura, Tsuzumi Konishi, Kimitoshi Saito, Satoshi Washino, Tomoaki Miyagawa, Masahiro Hiruta, Hisashi Oshiro, Noriko Oyama-Manabe, Katsuyuki Shirai
Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama, Japan., Department of Pathology, Jichi Medical University Saitama Medical Center, Saitama, Japan., Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan., Department of Urology, Jichi Medical University Saitama Medical Center, Saitama, Japan.