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Risk factors predicting the outcome of salvage radiotherapy in patients with biochemical recurrence after radical prostatectomy.
MedLine Citation:
PMID:  23293977     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: Salvage radiotherapy is the only curative treatment for patients with prostate cancer showing biochemical progression after radical prostatectomy. In this study, we evaluated the clinicopathological parameters that influence the outcome of salvage radiotherapy. METHODS: Medical records of 49 patients who underwent salvage radiotherapy after radical prostatectomy from 1997 to 2008 at the Graduate School of Medicine, Kyoto University, were retrospectively reviewed. Radiotherapy was carried out with 66 Gy on the prostatic bed. RESULTS: Biochemical progression-free survival after salvage radiotherapy at 2, 5 and 7 years was 51.0%, 42.2% and 42.2%, respectively. Significant parameters predicting biochemical progression after salvage radiotherapy by Cox regression analysis were prostatectomy Gleason score sum ≥8 (hazard ratio 0.08; 95% confidence interval 0.03-0.22; P = 0.001), prostate-specific antigen nadir after radical prostatectomy ≥0.04 ng/mL (hazard ratio 0.30; 95% confidence interval 0.13-0.69; P = 0.005) and negative surgical margin (hazard ratio 0.28; 95% confidence interval 0.12-0.70; P = 0.006). When the patients were subgrouped by these risk factors, the 5-year progression-free survival rates after salvage radiotherapy were 77.8%, 50.0% and 6.7% in patients with 0, 1 and ≥2 predictors, respectively. CONCLUSION: In order to discriminate favorable candidates for salvage radiotherapy, Gleason score of prostatectomy, prostate-specific antigen nadir after prostatectomy and positive surgical margin represent independent predictors. Thus, progression-free survival might be more precisely predicted according to the presence/absence of these risk factors. The significance of this risk classification should be confirmed by large prospective studies.
Authors:
Hidefumi Kinoshita; Yosuke Shimizu; Takashi Mizowaki; Kenji Takayama; Yoshiki Norihisa; Toshiyuki Kamoto; Tomomi Kamba; Yasuaki Hayashino; Masahiro Hiraoka; Osamu Ogawa
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-8
Journal Detail:
Title:  International journal of urology : official journal of the Japanese Urological Association     Volume:  -     ISSN:  1442-2042     ISO Abbreviation:  Int. J. Urol.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9440237     Medline TA:  Int J Urol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2013 The Japanese Urological Association.
Affiliation:
Department of Urology and Andrology, Kansai Medical University, Hirakata.
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