title: Patterns of care and outcomes of radiotherapy for lymph node positivity after radical prostatectomy.
abstract: OBJECTIVE
  To evaluate the use and outcomes of adjuvant radiation therapy (ART) for men with lymph node (LN)-positive disease after radical prostatectomy (RP) using a population-based approach.
  
  
  METHODS
  Surveillance, Epidemiology, and End Results (SEER)-Medicare linked data from 1995 to 2007 was used to identify 577 men with LN metastases discovered during RP and absence of distant metastases, of which 177 underwent ART ≤1 year of RP. Propensity score models were used to compare overall mortality and prostate cancer-specific mortality (PCSM) for men that did and those that did not receive ART.
  
  
  RESULTS
  Men in both groups received adjuvant androgen-deprivation therapy at similar rates after propensity weighting adjustments (33.6% vs 33.7%, P = 0.977). ART was not associated with differences in overall (5.09 vs 3.77 events per 100 person-years, P = 0.153) or PCSM (2.89 vs 1.31, P = 0.090) relative to men who did not receive ART.
  
  
  CONCLUSIONS
  ART after RP in men with LN-positive prostate cancer was not associated with improved overall or disease-specific survival, in contrast to previous single-centre studies. Prospective randomised studies are needed to assess the effectiveness of ART in this patient population.
authors.affiliation: Division of Urologic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. jrkaplan@partners.org
authors.forename: Joshua R
authors.initials: JR
authors.lastname: Kaplan
authors.forename: Keith J
authors.initials: KJ
authors.lastname: Kowalczyk
authors.forename: Tudor
authors.initials: T
authors.lastname: Borza
authors.forename: Xiangmei
authors.initials: X
authors.lastname: Gu
authors.forename: Stuart R
authors.initials: SR
authors.lastname: Lipsitz
authors.forename: Paul L
authors.initials: PL
authors.lastname: Nguyen
authors.forename: David F
authors.initials: DF
authors.lastname: Friedlander
authors.forename: Quoc-Dien
authors.initials: QD
authors.lastname: Trinh
authors.forename: Jim C
authors.initials: JC
authors.lastname: Hu
mesh_terms: D000368:Aged; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000532:radiotherapy* / Q000556:secondary / Q000601:surgery; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D018426:SEER Program; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology