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Salvage radiotherapy for biochemical recurrence after radical prostatectomy: does the outcome depend on the prostate cancer characteristics?
Viani, Gustavo Arruda; Hamamura, Ana Carolina; Correa, Alexandre Ciuffi; Arruda, Felipe Teles de.
  • Viani, Gustavo Arruda; Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto. Ribeirão Preto. BR
  • Hamamura, Ana Carolina; Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto. Ribeirão Preto. BR
  • Correa, Alexandre Ciuffi; Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto. Ribeirão Preto. BR
  • Arruda, Felipe Teles de; Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto. Ribeirão Preto. BR
Int. braz. j. urol ; 45(2): 237-245, Mar.-Apr. 2019. tab, graf
Article in English | LILACS | ID: biblio-1002192
ABSTRACT
ABSTRACT

Objective:

To build a model to evaluate the impact of salvage radiotherapy (SRT) in men with PSA rise or persistent PSA after undergoing radical prostatectomy (RP). Materials and

Methods:

The study included 107 node-negative patients treated with SRT after RP at a single institution. Patients received SRT for either prostate-specific antigen (PSA) rising, or PSA persistence after RP. All patients received local radiation to the prostate / seminal vesicle bed. The primary measured outcome was the biochemical recurrence (BCR) free survival. Multivariable Cox regression analysis was used to develop a risk-stratification group to identify predictive factors associated with the probability of BCR at 5yr.

Results:

At a median follow-up of 52 months, the BCR free survival rate and overall survival in 5 years was 73% and 94%, respectively. At multivariable analysis, pre-SRT PSA level > 0.35ng / mL (p = 0.023), negative margins (p = 0.038), and seminal vesicles invasion (p = 0.001) were significantly associated with BCR free survival. Three risk groups using regression analysis for SRT administration was built. Low-, intermediate- and the high-risk groups had a BCR free survival in 5-years of 96%, 84%, and 44% (p = 0.0001), respectively.

Conclusions:

We developed a risk group stratification to show the impact of SRT based on prostate cancer characteristics. SRT showed to be extremely beneficial for patients with low- and intermediate-risk tumors. Moreover, the risk-group built could identify patients classified as high-risk who might benefit from more aggressive treatment for SRT.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Prostatectomy / Prostatic Neoplasms / Salvage Therapy / Neoplasm Recurrence, Local Type of study: Etiology study / Observational study / Prognostic study / Risk factors Limits: Aged / Humans / Male Language: English Journal: Int. braz. j. urol Journal subject: Urology Year: 2019 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade de São Paulo/BR

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Full text: Available Index: LILACS (Americas) Main subject: Prostatectomy / Prostatic Neoplasms / Salvage Therapy / Neoplasm Recurrence, Local Type of study: Etiology study / Observational study / Prognostic study / Risk factors Limits: Aged / Humans / Male Language: English Journal: Int. braz. j. urol Journal subject: Urology Year: 2019 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade de São Paulo/BR