Is the Roach formula predictive for biochemical outcome in prostate cancer patients with minimal residual disease undergoing local radiotherapy after radical prostatectomy?
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.
Goldner
Gregor
G
Department of Radiotherapy, University of Vienna Medical School, Austria. Gregor.Goldner@akhwien.at
Dimopoulos
Johannes
J
Pötter
Richard
R
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
D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen