Radical prostatectomy in high-grade prostate cancer, salvage and adjuvant radiotherapy

Urol Int. 2011;86(2):146-51. doi: 10.1159/000320494. Epub 2010 Oct 22.

Abstract

Introduction: Prostate cancer with a Gleason score (GS) of 8-10 is linked to a higher risk of recurrence and progression. The aim of this paper is to evaluate treatment results of our high-risk patient cohort.

Patients and methods: The cohort of 42 patients with radical prostatectomy (RP) specimen histology GS 8-10 was assessed. The patients were followed up after RP and radiotherapy (RT) was delivered in case of a biochemical relapse. Adjuvant radiotherapy (aRT) was delivered only in case of a positive surgical margin (PSM). The following parameters were evaluated: biochemical progression-free survival (BPFS), overall survival (OS) and cancer-specific survival (CSS). The second objective was to evaluate adverse effects of RP and RT.

Results: The median follow-up time was 88 months (18-168). RP led to BPFS in 16 patients (38%). Five patients with PSM underwent aRT and 20 underwent salvage radiotherapy (sRT). One patient died of myocardial infarction and 1 patient died of metastatic disease. Skeletal metastases were recorded in 2 patients. The BPFS in RP combinations with sRT or aRT was reached in 29 patients (69%). The OS and CSS in our cohort reached 95 and 98%, respectively.

Conclusion: Management with aRT only in PSM was very effective, according to our retrospective study.

MeSH terms

  • Cohort Studies
  • Disease Progression
  • Disease-Free Survival
  • Humans
  • Male
  • Medical Oncology / methods
  • Neoplasm Metastasis
  • Prostatectomy / methods*
  • Prostatic Neoplasms / radiotherapy*
  • Prostatic Neoplasms / surgery*
  • Radiotherapy / methods*
  • Radiotherapy, Adjuvant / methods*
  • Recurrence
  • Retrospective Studies
  • Risk
  • Salvage Therapy / methods*
  • Treatment Outcome