Long-term Outcomes Following Radiation Therapy For Prostate Cancer Patients With Lymph Node Metastases at Diagnosis Treated With and Without Surgery.
OBJECTIVE
To evaluate the long-term outcomes for prostate cancer (PCa) patients with lymph node involvement (LNI) treated with radiotherapy at the University of California San Francisco.


METHODS
All newly diagnosed PCa patients with LNI treated with radiotherapy as primary therapy or after surgery, each with and without hormonal therapy (HT) between 1988 and 2009 were included.Thirty-five patients (38%) were managed with external beam radiotherapy alone (eRT), 18 patients (20%) with radical prostatectomy (RP)+adjuvant radiotherapy, and 38 patients (42%) with RP+salvage radiotherapy. Overall 82% of the study sample received HT with similar proportions among radiation therapy (RT) subsets (P=0.83).


RESULTS
The median follow-up (FU) was 65, 42, and 86 months for patients treated with eRT, adjuvant radiotherapy, and salvage radiotherapy, respectively.The 10-year estimates from start of primary therapy for patients with LNI for overall survival (OS) was 78% (95% confidence interval [CI], 62%-88%) and for cause-specific survival was 89% (95% CI, 78%-95%). The 5-year estimates from the start of RT for biochemically no evidence of disease was 68% (95% CI, 56%-78%) and for disease-free survival was 67% (95% CI, 54%-77%). There was no difference in any of these outcomes among the 3 RT groups.Patients treated with HT were more likely to have a better 10-year OS (82% vs. 66%; log rank: P=0.001).Multivariate analysis indicated that only age and Gleason score were significant predictors for biochemically no evidence of disease and OS.


CONCLUSIONS
Patients diagnosed with PCa with LNI who were treated with RT with or without a prior surgery had relatively favorable long-term outcomes.
*Department of Radiation Oncology †UCSF, Biostatistics Core ‡Department of Urology, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA.
Gilles
G
Crehange
Alejandra
A
Izaguirre
Vivian
V
Weinberg
Charles C
CC
Hsu
Alexander R
AR
Gottschalk
I-Chow
IC
Hsu
Katsuto
K
Shinohara
Peter
P
Carroll
Mack
M
Roach
D000368:Aged; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D006801:Humans; D008207:Lymphatic Metastasis / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000532:radiotherapy* / Q000601:surgery*; D011878:Radiotherapy; D012189:Retrospective Studies; D013995:Time; D016896:Treatment Outcome