title: Salvage radiation therapy following radical prostatectomy. A national Danish study.
abstract: BACKGROUND
  The purpose of this observational cohort study was to evaluate the outcome and prognostic factors following salvage radiotherapy (SRT) in a consecutive national cohort.
  
  
  METHODS
  Between 2006 and 2010, 259 patients received SRT in Denmark. Patient- and cancer-related characteristics were retrospectively retrieved from patient charts. The primary end point was biochemical progression-free survival (b-PFS).
  
  
  RESULTS
  At the end of follow-up, 51% of the patients displayed a prostate-specific antigen (PSA) level <0.1 ng/ml. The three-year b-PFS rate for the total cohort was 57.0%. Nearly half of the patients (44%) received androgen deprivation therapy (ADT) in combination with SRT. Positive surgical tumour margins (p = 0.025) and ADT (p = 0.001) were the only markers independently correlated with b-PFS. In patients who received SRT without ADT, both a pre-SRT PSA level ≤0.5 ng/ml (p = 0.003) and pathological tumour stage T1-T2 (p = 0.036) independently correlated with b-PFS. Moreover, a duration between radical prostatectomy (RP) and SRT ≤29 months (p = 0.035) independently correlated with b-PFS in patients treated with ADT in combination with RT.
  
  
  CONCLUSIONS
  In patients treated for biochemical failure after RP, positive surgical tumour margins and PSA levels ≤0.5 ng/mL at the time of SRT were associated with a favourable outcome. Despite less favourable tumour characteristics, patients receiving SRT and ADT demonstrated improved b-PFS, and in particular, patients with PSA levels >0.2 ng/ml benefitted from additional ADT.
authors.affiliation: a Department of Urology , Aarhus University Hospital , Aarhus N , Denmark .
authors.forename: Maria
authors.initials: M
authors.lastname: Ervandian
authors.affiliation: b Department of Oncology , Aarhus University Hospital , Aarhus C , Denmark .
authors.forename: Morten
authors.initials: M
authors.lastname: Høyer
authors.affiliation: b Department of Oncology , Aarhus University Hospital , Aarhus C , Denmark .
authors.forename: Stine Elleberg
authors.initials: SE
authors.lastname: Petersen
authors.affiliation: c Department of Oncology , Herlev Hospital , Herlev , Denmark .
authors.forename: Lisa
authors.initials: L
authors.lastname: Sengeløv
authors.affiliation: d Department of Oncology , Odense University Hospital , Odense C , Denmark .
authors.forename: Steinbjørn
authors.initials: S
authors.lastname: Hansen
authors.affiliation: e Department of Oncology , Aalborg University Hospital , Aalborg , Denmark , and.
authors.forename: Mats
authors.initials: M
authors.lastname: Holmberg
authors.affiliation: f Department of Oncology , Rigshospitalet , København Ø , Denmark.
authors.forename: Joen
authors.initials: J
authors.lastname: Sveistrup
authors.affiliation: f Department of Oncology , Rigshospitalet , København Ø , Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Meidahl Petersen
authors.affiliation: a Department of Urology , Aarhus University Hospital , Aarhus N , Denmark .
authors.forename: Michael
authors.initials: M
authors.lastname: Borre
mesh_terms: D000368:Aged; D000726:Androgen Antagonists / Q000627:therapeutic use*; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D000072662:Margins of Excision; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000532:radiotherapy*; D017410:Practice Guidelines as Topic; D011379:Prognosis; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods*; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000726:Androgen Antagonists; D017430:Prostate-Specific Antigen