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


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.


CONCLUSIONS
Management with aRT only in PSM was very effective, according to our retrospective study.
Department of Urology, University Hospital, Hradec Kralove, Czech Republic. brodak @ fnhk.cz
Milos
M
Brodak
Josef
J
Kosina
Lukas
L
Holub
Miroslav
M
Louda
Karel
K
Odrazka
Martin
M
Dolezel
Jana
J
Sefrová
Jan
J
Jansa
Jaroslav
J
Pacovsky
D015331:Cohort Studies; D018450:Disease Progression; D018572:Disease-Free Survival; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000379:methods; D009362:Neoplasm Metastasis; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D011878:Radiotherapy / Q000379:methods*; D018714:Radiotherapy, Adjuvant / Q000379:methods*; D012008:Recurrence; D012189:Retrospective Studies; D012306:Risk; D016879:Salvage Therapy / Q000379:methods*; D016896:Treatment Outcome