title: Impact of pathological tumor stage for salvage radiotherapy after radical prostatectomy in patients with prostate-specific antigen < 1.0 ng/ml.
abstract: BACKGROUND
  To evaluate prognostic factors in salvage radiotherapy (RT) for patients with pre-RT prostate-specific antigen (PSA) < 1.0 ng/ml.
  
  
  METHODS
  Between January 2000 and December 2009, 102 patients underwent salvage RT for biochemical failure after radical prostatectomy (RP). Re-failure of PSA after salvage RT was defined as a serum PSA value of 0.2 ng/ml or more above the postradiotherapy nadir followed by another higher value, a continued rise in serum PSA despite salvage RT, or initiation of systemic therapy after completion of salvage RT. Biochemical relapse-free survival (bRFS) was estimated using the Kaplan-Meier method. Multivariate analysis was performed using the Cox proportional hazards regression model.
  
  
  RESULTS
  The median follow-up period was 44 months (range, 11-103 months). Forty-three patients experienced PSA re-failure after salvage RT. The 4-year bRFS was 50.9% (95% confidence interval [95% CI]: 39.4-62.5%). In the log-rank test, pT3-4 (p < 0.001) and preoperative PSA (p = 0.037) were selected as significant factors. In multivariate analysis, only pT3-4 was a prognostic factor (hazard ratio: 3.512 [95% CI: 1.535-8.037], p = 0.001). The 4-year bRFS rates for pT1-2 and pT3-4 were 79.2% (95% CI: 66.0-92.3%) and 31.7% (95% CI: 17.0-46.4%), respectively.
  
  
  CONCLUSIONS
  In patients who have received salvage RT after RP with PSA < 1.0 ng/ml, pT stage and preoperative PSA were prognostic factors of bRFS. In particular, pT3-4 had a high risk for biochemical recurrence after salvage RT.
authors: Department of Radiation Oncology, Tohoku University School of Medicine, Seiryou-machi 1-1, Aobaku, Sendai, Japan. reirei513@hotmail.com
authors: Rei
authors: R
authors: Umezawa
authors: Hisanori
authors: H
authors: Ariga
authors: Yoshihiro
authors: Y
authors: Ogawa
authors: Keiichi
authors: K
authors: Jingu
authors: Haruo
authors: H
authors: Matsushita
authors: Ken
authors: K
authors: Takeda
authors: Keisuke
authors: K
authors: Fujimoto
authors: Toru
authors: T
authors: Sakayauchi
authors: Toshiyuki
authors: T
authors: Sugawara
authors: Masaki
authors: M
authors: Kubozono
authors: Kakutaro
authors: K
authors: Narazaki
authors: Eiji
authors: E
authors: Shimizu
authors: Yoshihiro
authors: Y
authors: Takai
authors: Shogo
authors: S
authors: Yamada
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D016016:Proportional Hazards Models; D017430:Prostate-Specific Antigen / Q000096:biosynthesis; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000378:metabolism / Q000532:radiotherapy* / Q000601:surgery*; D011878:Radiotherapy / Q000379:methods*; D012008:Recurrence; D016879:Salvage Therapy / Q000379:methods*; D013997:Time Factors
chemical_list: D017430:Prostate-Specific Antigen