title: Prostate-specific antigen doubling time subsequent to radical prostatectomy is a predictor of outcome following salvage external beam radiation therapy: a single-centre experience.
abstract: OBJECTIVE
  The aim of this study was to review the impact of salvage external beam radiotherapy (EBRT) of postprostatectomy patients with long-term follow-up on biochemical-free recurrence (BFR) and metastatic-free survival, and to describe pathological and clinical predictors of outcome.
  
  
  METHODS
  In the period 1987-2010, 76 postprostatectomy patients with biochemical and clinical recurrence received salvage EBRT. Patients were treated with conformal EBRT and 68 (90%) received a dose of 70 Gy; eight patients (10%) received a dose of 60-64 Gy. No patients received adjuvant or neoadjuvant androgen deprivation therapy in conjunction with salvage EBRT.
  
  
  RESULTS
  The median follow-up time after salvage EBRT was 82 months (range 5-192 months). Seventeen patients (22%) developed biochemical recurrence subsequent to postprostatectomy salvage EBRT during the observation time, and the overall 50 and 75 month actuarial BFR rates after salvage EBRT were 84% and 79%, respectively. Seven patients (9%) developed metastatic disease and two patients died of prostate cancer. Independent predictors of biochemical recurrence were seminal vesicle invasion (SVI) in the prostatectomy specimen (p < 0.05) and prostate-specific antigen doubling time (PSADT) of 6 months or less (p = 0.041) before salvage EBRT.
  
  
  CONCLUSIONS
  Salvage EBRT provides effective long-term BFR and metastatic-free survival in a selected group of patients with detectable, rising prostate-specific antigen values following radical prostatectomy. SVI and PSADT are prognostic variables for a non-durable response to salvage EBRT and thus predictors of high-risk prostate cancer in patients in whom neoadjuvant and adjuvant androgen deprivation therapy should be considered.
authors.affiliation: Section of Urology, Sørlandet County Hospital , Arendal , Norway , and.
authors.forename: Einar
authors.initials: E
authors.lastname: Servoll
authors.forename: Thorstein
authors.initials: T
authors.lastname: Sæter
authors.forename: Ljiljana
authors.initials: L
authors.lastname: Vlatkovic
authors.forename: Jahn M
authors.initials: JM
authors.lastname: Nesland
authors.forename: Gudmund
authors.initials: G
authors.lastname: Waaler
authors.forename: Karol
authors.initials: K
authors.lastname: Axcrona
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D003131:Combined Modality Therapy; D004307:Dose-Response Relationship, Radiation; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D011237:Predictive Value of Tests; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000097:blood / Q000532:radiotherapy* / Q000601:surgery*; D011878:Radiotherapy; D012189:Retrospective Studies; D016879:Salvage Therapy; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen
keywords: Biochemical recurrence; prostate-specific antigen doubling time; salvage external beam radiotherapy