title: Radiation therapy for clinically node-positive prostate adenocarcinoma is correlated with improved overall and prostate cancer-specific survival.
abstract: OBJECTIVE
  To evaluate the effect of radiation therapy on prostate cancer-specific and overall survival with node-positive cancer in a retrospective Surveillance, Epidemiology and End RESULTS (SEER) population based study.
  
  
  METHODS
  The survival of subjects with cT1-T4,cN1,M0 prostate adenocarcinoma diagnosed between 1988 and 2006 were compared with univariate and multivariate Cox regression analysis.
  
  
  RESULTS
  A total of 1100 subjects, with a median age of 69 years and median follow-up time of 90 months, were identified. The 10-year cancer-specific survival for men who had no definitive therapy was 50.3% and for those who had radiation therapy 62.7%. This was significantly different favoring radiation therapy (hazard ratio [HR] = 0.66, 95% confidence interval [CI] = 0.54 to 0.82, P ≤ .01). On multivariate analysis evaluating age, histologic grade, T stage, year of diagnosis, marital status, SEER registry and radiation therapy, radiation therapy (HR = 0.67, 95% CI = 0.54 to 0.84, P ≤ .01), year of diagnosis (HR = 0.96, 95% CI = 0.93 to 0.99, P = .01), and low and intermediate grade disease were correlated with improved CSS. The number needed to treat to prevent 1 prostate cancer-specific death at 10 years was 8 persons. A cause of death analysis revealed non-prostate cancer deaths were not statistically different in the comparison groups.
  
  
  CONCLUSIONS
  Radiation therapy is correlated with a clinically significant reduction in all cause and prostate cancer-specific death.
authors.affiliation: Department of Radiation Oncology, University of Utah, Salt Lake City, Utah; Huntsman Cancer Institute, Salt Lake City, Utah. Electronic address: jonathan.tward@hci.utah.edu.
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Tward
authors.affiliation: Department of Radiation Oncology, University of Utah, Salt Lake City, Utah; Huntsman Cancer Institute, Salt Lake City, Utah.
authors.forename: Kristine E
authors.initials: KE
authors.lastname: Kokeny
authors.affiliation: Department of Radiation Oncology, University of Utah, Salt Lake City, Utah; Huntsman Cancer Institute, Salt Lake City, Utah.
authors.forename: Dennis C
authors.initials: DC
authors.lastname: Shrieve