title: Is the Roach formula predictive for biochemical outcome in prostate cancer patients with minimal residual disease undergoing local radiotherapy after radical prostatectomy?
abstract: OBJECTIVE
  To find out if the risk of biochemical failure can be predicted applying the risk assessment for lymph-node metastases as suggested by the Roach formula for patients with minimal residual disease after radical prostatectomy undergoing adjuvant radiotherapy.
  
  
  METHODS
  Patients after radical prostatectomy presenting with pT3-tumours or positive surgical margins, negative nodes and with a post-operative and pre-radiotherapy PSA level <or=0.1 ng/ml and without hormonal therapy were selected. Patients had received local 3D-conformal radiotherapy in the prostatic region with 66-72 Gy. According to the risk stratification of the Roach formula patients were divided into two groups: Group 1 with probability of positive lymph-nodes <15% and Group 2 with >or=15%. Biochemical recurrence was defined by reaching a PSA level >or=0.2 ng/ml.
  
  
  RESULTS
  A total of 55/288 patients could be identified, 26 patients in Group 1 and 29 patients in Group 2. Mean follow-up was 45 months. Biochemical recurrence free survival after 5 years was 78% for all patients and showed a significant difference between Group 1 (100%) and Group 2 with (58%; p=0.004).
  
  
  CONCLUSIONS
  The risk for biochemical failure after adjuvant radiotherapy in post-operative patients presenting with minimal residual disease is significantly influenced by the Roach formula. These findings are considered to provide a rationale for the decision on the volume of post-operative radiotherapy.
authors.affiliation: Department of Radiotherapy, University of Vienna Medical School, Austria. Gregor.Goldner@akhwien.at
authors.forename: Gregor
authors.initials: G
authors.lastname: Goldner
authors.forename: Johannes
authors.initials: J
authors.lastname: Dimopoulos
authors.forename: Richard
authors.initials: R
authors.lastname: Pötter
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D018365:Neoplasm, Residual; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen