Pathological T3 and/or margin positive prostate adenocarcinoma with undetectable postoperative PSA - to irradiate or not?: analysis of freedom from PSA failure.
We retrospectively analyzed 48 patients with pathological T3 (PT3) and/or margin positive disease who had undetectable or unknown postoperative serum prostate specific antigen (PSA) following radical prostatectomy. Twenty-nine patients received postoperative adjuvant radiotherapy (RT) while 19 did not. Follow-up ranged from 0.5 to 6.9 years with a median of 3.4 years for the irradiated group and 2.9 years for the surgery alone group. PSA outcome was available on all patients. Freedom from failure was defined as the maintenance of a serum PSA level of < 0.2 ng/ml and the absence of clinical local recurrence and distant metastasis. Actuarial overall survival was 92% for the entire group and showed no difference between the irradiated and non-irradiated groups. However, the 5-year actuarial disease free survival including freedom from PSA failure was statistically better in those treated with adjuvant RT than that in the surgery alone group (88% vs 46%, p=0.0035). The morbidity of adjuvant RT was acceptable with only 2 patients developing Grade 3 genitourinary complication.
Flavin
A.
A
Department of Radiation Oncology, University of Toronto, Toronto-Sunnybrook Regional Cancer Centre, Toronto, Ontario.
Choo
R.
R
Franssen
E.
E
Danjoux
C.
C
Morton
G.
G