| A multi-institutional matched-control analysis of adjuvant and salvage postoperative radiation therapy for pT3-4N0 prostate cancer. | |
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MedLine Citation:
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PMID: 18672274 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: It is unclear whether postoperative salvage radiation therapy (SRT) and early adjuvant radiotherapy (ART) after radical prostatectomy lead to equivalent long-term tumor control. We studied a group of patients undergoing ART by comparing them with a matched control group undergoing SRT after biochemical failure. METHODS: Using a multi-institutional database of 2299 patients, 449 patients with pT3-4N0 disease were eligible for inclusion, including 211 patients receiving ART and 238 patients receiving SRT. Patients were matched in a 1:1 ratio according to preoperative prostate-specific antigen Gleason score, seminal vesicle invasion, surgical margin status, and follow-up from date of surgery. RESULTS: A total of 192 patients were matched (96:96). The median follow-up was 94 months from surgery and 73 months from RT completion. There was a significant reduction in biochemical failure with ART compared with SRT. The 5-year freedom from biochemical failure (FFBF) from surgery was 75% after ART, compared with 66% for SRT (hazard ratio [HR] = 1.6, P = .049). The 5-year FFBF from the end of RT was 73% after ART, compared with 50% after SRT (HR = 2.3, log rank [LR] P = .0007). From the end of RT, SRT and Gleason score >or=8 were independent predictors of diminished FFBF. From the date of surgery, Gleason score >or=8 was a significant predictor of FFBF. CONCLUSIONS: Early ART for pT3-4N0 prostate cancer significantly reduces the risk of long-term biochemical progression after radical prostatectomy compared with SRT. Gleason score >or=8 was the only factor on multivariate analysis associated with metastasic progression. |
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Authors:
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Edouard J Trabulsi; Richard K Valicenti; Alexandra L Hanlon; Thomas M Pisansky; Howard M Sandler; Deborah A Kuban; Charles N Catton; Jeff M Michalski; Michael J Zelefsky; Patrick A Kupelian; Daniel W Lin; Mitchell S Anscher; Kevin M Slawin; Claus G Roehrborn; Jeffrey D Forman; Stanley L Liauw; Larry L Kestin; Theodore L DeWeese; Peter T Scardino; Andrew J Stephenson; Alan Pollack |
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Publication Detail:
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Type: Journal Article; Multicenter Study Date: 2008-07-30 |
Journal Detail:
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Title: Urology Volume: 72 ISSN: 1527-9995 ISO Abbreviation: Urology Publication Date: 2008 Dec |
Date Detail:
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Created Date: 2008-12-01 Completed Date: 2009-01-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0366151 Medline TA: Urology Country: United States |
Other Details:
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Languages: eng Pagination: 1298-302; discussion 1302-4 Citation Subset: IM |
Affiliation:
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Department of Urology, Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Case-Control Studies Humans Male Middle Aged Multivariate Analysis Postoperative Period Proportional Hazards Models Prostatic Neoplasms / radiotherapy*, surgery* Radiotherapy / methods* Salvage Therapy / methods* Time Factors Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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