title: The impact of adjuvant therapy in patients with biochemical recurrence on prostate cancer progression and mortality five years after radical prostatectomy.
abstract: BACKGROUND
  The clinical significance of biochemical recurrence (BCR) after radical prostatectomy (RP) due to prostate cancer (PCa) is not unambiguous, sometimes being independent from the real progression. BCR is followed by a greater risk of adverse events and almost always results with the necessity for implementation of adjuvant therapy (AT). The aim of the following study was to examine the impact of AT in patients with BCR together with PCa progression and mortality 5-years after RP.
  
  
  METHODS
  Two hundred forty-seven patients after RP, who were treated in the period from 1995 to 2009, underwent the retrospective analysis. They were divided into three groups according to the applied AT after prior BCR diagnosis. The first group (n - 39) included patients treated with radiotherapy, along with hormonotherapy. The second group (n - 63) covers patients receiving hormonotherapy only. The third group (n - 145) consists of patients without BCR. Five-year general and disease-specific survival was evaluated and choice prognostic factors were compared.
  
  
  RESULTS
  Five-year overall survival was 74.2% in group I, 88.3% in group II, and 98.7% in group III. Diseasespecific survival was: 76.9%, 90.5%, and 100% (p = 0.001), respectively. BCR was diagnosed in 102 (41.5%) patients; while in another 24 (23.5%) of them progression was diagnosed after the AT was applied.
  
  
  CONCLUSIONS
  The risk of BCR 5-years after RP is greater in patients with high initial concentration of PSA, higher Gleason score, and clinical advancement. Five-year overall and disease-specific survivals are higher among patients after hormonotherapy alone compared to those after both radio- and hormonotherapy.
authors.affiliation: Department of Urology, Medical University of Silesia in Katowice, Zabrze, Poland.
authors.forename: Mieczysław
authors.initials: M
authors.lastname: Fryczkowski
authors.affiliation: Department of Urology, Medical University of Silesia in Katowice, Zabrze, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Bryniarski
authors.affiliation: Department of Urology, Medical University of Silesia in Katowice, Zabrze, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Szczębara
authors.affiliation: Department of Urology, Medical University of Silesia in Katowice, Zabrze, Poland.
authors.forename: Marian
authors.initials: M
authors.lastname: Suchodolski
authors.affiliation: Department of Urology, Medical University of Silesia in Katowice, Zabrze, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Paradysz
keywords: cancer; hereditary prostate; prostate; prostate cancer