Biochemical failure of surgical stage T3N0 prostate carcinoma with or without adjuvant radiotherapy
Biokemično dokazan recidiv karcinoma prostate stadij T3N0 ali brez adjuvantne radioterapije

english

1999

volume 33, issue 2

Onkološki inštitut Ljubljana

Background. Patients with extracapsular extension or seminal vesicle involvement of prostate adenocarcinoma are known to have a worse prognosis than patients without these adverse features. Multiple, studies have assessed the impact of adjuvant postoperative radiotherapy on clinical outcome, but there, are fewer studies examining the effect on biochemical (prostate specific antigen or PSA) failure. Methods. This is a retrospective analysis of100 patients found to have prostate adenocarcinorna extending through the prostatic capsule or involving the seminal vesicles (stage T3) after prostatectomy. Thirty-one patients received adjuvant radiotherapy to the prostatic bed and 69 patients did not receive radiotherapy. Prognostic factorswere not evenly distrubuted between the two groups. Mean follow-up was 60 months. Results. Actuarial freedom from PSA failure at 5 and 10 years was 64 % and 31 %, respectively, in the group that received radiotherapy. For the non-irradiated group, the results for the same endpoint were 55%, and 30% at 5and 10 years (p=.76). The only endpoint analyzed which was significantly improved with adjuvant radiotherapy was clinical local control, which was 95% at 10 years for the radiotherapy group and 65'% at 10 years for the non-irradiated group (p=.03). Among patients who received radiotherapy, biochemical failure was similar when comparing patients with or without seminal vesicle involvement. Potency in patients undergoing nerve sparing prostatectorny was not affected by postoperative radiotherapy. Conclusions. Adjuvant radiotherapy after prostatectomy in patients with stage T3 disease significantly reduced the clinical local failure rate, but did not improve thebiochemical failure rate or overall survival. The benefit of adjuvant radiotherapy should be tested in clinical trials.

10.11.2023