OBJECTIVE: To analyze the influential factors in the response in prostatectomized patients with subsequent biochemical relapse (BCR) and treated with salvage radiotherapy (RTP).
MATERIAL AND METHODS: We analyzed 313 patients with pT2/pT3 prostate cancer who were receiving salvage therapy due to biochemical relapse (from a series of 1,310 radical prostatectomies between 1989-2012). Of the 313 patients; 159 (50.8%) only received androgen deprivation (AD), 63 (20.1%) Radiotherapy (RTP) plus concomitant AD and 91 (29.1%) only RTP. Of these, 57 (62.6%) have maintained complete response and 34 (37.4%) had failure response with post-RTP BCR.
RESULTS: Study of the group treated exclusively with salvage RTP. Ninety-one patients were treated with salvage RTP. Median follow-up was 6.4 years and median to recurrence 11 months. Post-RTP biochemical relapse-free survival (PRBRFS) was 68±7% and 30±10% in 5 to 10 years. Median PRBRFS was 7.3 years (6.3-8.3). Initial PSA (HR: 1.08; 95% CI: 1.01-1.1 P= .02) with best PSA cut-off point PSA > 20ng/ml (HR: 13.6; 95% CI: 2.1-86 P= .005) and PSA pre-RTP (HR: 1.9; 95% CI: 1.2-3.3; P=.009), best PSA cut-off point PSA preRTP 0.92 ng/ml (HR: 4.5; 95% CI: 1.3-15.6; P=.01) showed independent influence in the response in the multivariate study. PRBRFS at 5 years, 81±9% versus 58±9% with initial PSA < 20 or > 20 ng/ml (P= .03). PRBRFS at 5 years, 93±5% versus 53±10% according to PSA pre-RTP < 0.9 or > 0.9 ng/ml (P= .02).
CONCLUSIONS: In patients treated with salvage RTP after radical prostatectomy, the preoperative PSA > 20ng/ml and PSA preRTP > 0.92 ng/ml shows an independent influence on the response.
Written by:
Algarra R, Tienza A, Hevia M, Zudaire J, Rosell D, Robles JE, Pascual I. Are you the author?
Departamento de Urología, Clínica Universidad de Navarra, Pamplona, España.
Reference: Actas Urol Esp. 2014 May 2. pii: S0210-4806(14)00092-8.
doi: 10.1016/j.acuro.2014.03.005
PubMed Abstract
PMID: 24796523
Article in English, Spanish.
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