Benefit on biochemical control of adjuvant radiation therapy in patients with pathologically involved seminal vesicles after radical prostatectomy

Carlo Greco, Simona Castiglioni, Andrei Fodor, Ottavio De Cobelli, Nadia Longaretti, Bernardo Rocco, Andrea Vavassori, Roberto Orecchia

Research output: Contribution to journalArticle

Abstract

Aims and background: To determine whether there is a benefit for biochemical control with adjuvant radiation therapy to the surgical bed following radical prostatectomy in patients with seminal vesicle invasion and pathologically negative pelvic lymph nodes (pT3b-pT4 pN0). Methods: We retrospectively reviewed the clinical records of radical prostatectomy patients treated between 1995 and 2002. A total of 66 patients with seminal vesicle invasion were identified: 45 of these patients received adjuvant radiation therapy and 21 were observed. Radiation therapy was initiated within 4 months of prostatectomy. Median dose was 66 Gy (range, 60-70 Gy). Median follow-up from the day of surgery was 40.6 months (mean, 41.5; range, 12-99). Biochemical recurrence was defined as the first value ≥0.2 ng/ml. Results: At two years, the proportion of patients free from biochemical recurrence was 80% in patients who received adjuvant radiation therapy versus 54% for those not given radiation therapy (P = 0.036). Actuarial biochemical recurrence at 5 years was 59% vs 41% for the radiation therapy and no radiation therapy groups, respectively. On univariate Cox regression model, the hazard of biochemical failure was also associated with a detectable (≥0.2 ng/ml) postsurgical prostate-specific antigen (P = 0.02) prior to radiation therapy. Pathological T stage (pT3b vs pT4), Gleason score, primary Gleason pattern and positive surgical margins were not significantly associated with biochemical recurrence. The hazard of biochemical failure was around 85% lower in the radiation therapy group than in the observation group (P = 0.002). Conclusions: Data from the present series suggest that adjuvant radiation therapy for patients with seminal vesicle invasion and undetectable (≤0.2 ng/ml) postoperative prostate-specific antigen significantly reduces the likelihood of biochemical failure.

Original languageEnglish
Pages (from-to)445-451
Number of pages7
JournalTumori
Volume93
Issue number5
Publication statusPublished - Sep 2007

Keywords

  • Biochemical failure
  • Conformal radiotherapy
  • Prostatectomy
  • Seminal vesicle invasion

ASJC Scopus subject areas

  • Cancer Research

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