title: The need for, and utilization of prostate-bed radiotherapy after radical prostatectomy for patients with prostate cancer in British Columbia.
abstract: BACKGROUND
  Three randomized trials have demonstrated that post-radical prostatectomy (RP) radiotherapy decreases biochemical relapse for those with adverse pathology. Our purpose was to describe the incidence of pathologic risk factors for recurrence in a contemporary series of patients treated with RP and to describe the use of post-RP radiotherapy.
  
  
  METHODS
  All incident prostate cancers diagnosed between January 2005 and December 2007 were identified from the tumour registry. Cases were then linked to radiotherapy records which included dose and modality (external beam radiotherapy and brachytherapy). The pathology reports in the tumour registry were reviewed for pathologic stage, grade and margin status.
  
  
  RESULTS
  We identified 9223 patients with prostate cancer. Overall, 36.3% of patients treated with RP had positive margins, and may have benefited from adjuvant radiotherapy. After RP, 332 (15%) patients had radiotherapy to the prostate bed; of these, only 25 (1.1%) received truly adjuvant radiotherapy (delivered within 6 months with a prostate-specific antigen of <0.2 ng/mL). Of the 2181 patients treated with RP, 270 (12%) were seen by a radiation oncologist within 6 months of RP. Of the 1015 patients (47%) with adverse RP pathology (positive margins, extracapsular extension or seminal vesicle invasion), 230 (23%) were seen by a radiation oncologist within 6 months of RP.
  
  
  CONCLUSIONS
  Not all patients with adverse prostatectomy pathology were seen by a radiation oncologist post-prostatectomy, and very few received adjuvant radiotherapy despite almost half of them having risk factors for relapse.
authors.affiliation: Department of Radiation Oncology, Vancouver Cancer Centre, BC Cancer Agency, Vancouver, BC.
authors.forename: Scott
authors.initials: S
authors.lastname: Tyldesley
authors.forename: Michael
authors.initials: M
authors.lastname: Peacock
authors.forename: James W
authors.initials: JW
authors.lastname: Morris
authors.forename: Alan
authors.initials: A
authors.lastname: So
authors.forename: Charmaine
authors.initials: C
authors.lastname: Kim-Sing
authors.forename: Jill
authors.initials: J
authors.lastname: Quirt
authors.forename: Michael
authors.initials: M
authors.lastname: Carter
authors.forename: Tom
authors.initials: T
authors.lastname: Pickles