title: Influential factors in the response to salvage radiotherapy after radical prostatectomy.
abstract: OBJECTIVE
  To analyze the influential factors in the response in prostatectomized patients with subsequent biochemical relapse (BCR) and treated with salvage radiotherapy (RTP).
  
  
  METHODS
  We analyzed 313 patients with pT2/pT3 prostate cancer who were receiving salvage therapy due to biochemical relapse (from a series of 1,310 radical prostatectomies between 1989-2012). Of the 313 patients; 159 (50.8%) only received androgen deprivation (AD), 63 (20.1%) Radiotherapy (RTP) plus concomitant AD and 91 (29.1%) only RTP. Of these, 57 (62.6%) have maintained complete response and 34 (37.4%) had failure response with post-RTP BCR.
  
  
  RESULTS
  Study of the group treated exclusively with salvage RTP. Ninety-one patients were treated with salvage RTP. Median follow-up was 6.4 years and median to recurrence 11 months. Post-RTP biochemical relapse-free survival (PRBRFS) was 68 ± 7% and 30 ± 10% in 5 to 10 years. Median PRBRFS was 7.3 years (6.3-8.3). Initial PSA (HR: 1.08; 95% CI: 1.01-1.1 P=.02) with best PSA cut-off point PSA>20 ng/ml (HR: 13.6; 95% CI: 2.1-86 P=.005) and PSA pre-RTP (HR: 1.9; 95% CI: 1.2-3.3; P=.009), best PSA cut-off point PSA preRTP 0.92 ng/ml (HR: 4.5; 95% CI: 1.3-15.6; P=.01) showed independent influence in the response in the multivariate study. PRBRFS at 5 years, 81 ± 9% versus 58 ± 9% with initial PSA <20 or >20 ng/ml (P=.03). PRBRFS at 5 years, 93 ± 5% versus 53 ± 10% according to PSA pre-RTP <0.9 or >0.9 ng/ml (P=.02).
  
  
  CONCLUSIONS
  In patients treated with salvage RTP after radical prostatectomy, the preoperative PSA>20 ng/ml and PSA preRTP>0.92 ng/ml shows an independent influence on the response.
authors.affiliation: Departamento de Urología, Clínica Universidad de Navarra, Pamplona, España. Electronic address: ralgarra@unav.es.
authors.forename: R
authors.initials: R
authors.lastname: Algarra
authors.affiliation: Departamento de Urología, Clínica Universidad de Navarra, Pamplona, España.
authors.forename: A
authors.initials: A
authors.lastname: Tienza
authors.affiliation: Departamento de Urología, Clínica Universidad de Navarra, Pamplona, España.
authors.forename: M
authors.initials: M
authors.lastname: Hevia
authors.affiliation: Departamento de Urología, Clínica Universidad de Navarra, Pamplona, España.
authors.forename: J
authors.initials: J
authors.lastname: Zudaire
authors.affiliation: Departamento de Urología, Clínica Universidad de Navarra, Pamplona, España.
authors.forename: D
authors.initials: D
authors.lastname: Rosell
authors.affiliation: Departamento de Urología, Clínica Universidad de Navarra, Pamplona, España.
authors.forename: J E
authors.initials: JE
authors.lastname: Robles
authors.affiliation: Departamento de Urología, Clínica Universidad de Navarra, Pamplona, España.
authors.forename: I
authors.initials: I
authors.lastname: Pascual
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy*; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D012189:Retrospective Studies; D016879:Salvage Therapy; D016896:Treatment Outcome
keywords: Antígeno prostático específico; Biochemical relapse; Cancer de próstata; Progresión bioquímica; Prostate neoplasm; Prostate specific antigen; Prostatectomía radical; Radiation therapy; Radical prostatectomy; Radioterapia; Salvage therapy; Tratamiento de rescate