[Salvage radiotherapy outcomes for biochemical recurrence following radical prostatectomy among the African-Caribbean population of Guadeloupe].
OBJECTIVE
To make the first analysis of the salvage radiotherapy outcomes for biochemical recurrence of prostate cancer after radical prostatectomy in African descendant people, witch has no healthcare access difficulties: the French West-Indies African-Caribbean people of Guadeloupe.


METHODS
Ninety successive patients, with biological failure after radical prostatectomies were treated in the University Hospital of Pointe-à-Pitre with salvage radiotherapy between April 2003 and December 2008. The retrospective study analysed the biochemical disease free survival (bDFs) after irradiation with Kaplan-Meier method, and the independent predictors of bDFs using the Cox model, with P<0.05. The treatment failure was defined for PSA superior or equal to nadir +0.1 ng/mL.


RESULTS
The median dose was 64 Gy. At the median follow-up of 24.63 months, 35 (38.9%) patients had biochemical recurrence. The median bDFs was 55.3 months, the bDFs probabilities at months 12, 24, 36 and 48 were 8.1%, 70.3%, 61.9% and 56.1%. Multivariate analysis determined that the independents predictors of treatment failure were the seminals vesicles invasion (P=0.0094, Hazard ratio=2.63 CI 95%: [1.28-5.55]), the PSA velocity superior or equal to 0.75 ng/mL per year (P=0.0002, Hazard ratio=3.88 CI95%: [1.86-7.75]) and the pre-irradiation PSA level superior or equal to 1.5 ng/mL (P=0.0093, Hazard ratio=2.89 CI95%: [1.30-6.45]).


CONCLUSIONS
Salvage radiotherapy for African descendent people with no healthcare difficulty access was an efficient treatment for the biochemical recurrence and had the same outcomes than others Caucasian people.
Service d'urologie, CHU de Pointe-à-Pitre, Pointe-à-Pitre, Guadeloupe. gabin.agoua@chu-guadeloupe.fr
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Agoua
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Vian
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Dumoulin
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Blanchet
D000230:Adenocarcinoma / Q000097:blood / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D015415:Biomarkers / Q000097:blood; D044383:Black People / Q000706:statistics & numerical data*; D017691:Caribbean Region / Q000453:epidemiology; D005500:Follow-Up Studies; D019430:Guadeloupe / Q000453:epidemiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000097:blood / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods / Q000401:mortality; D012680:Sensitivity and Specificity; D017211:Treatment Failure; D016896:Treatment Outcome
D015415:Biomarkers; D017430:Prostate-Specific Antigen