Results of early or delayed adjuvant radiotherapy for prostate cancer with adverse pathological tumor characteristics: A single-institute experience

Abstract

Objective: Despite an earlier detection of prostate cancer (Pca) is promising, pathologically advanced disease still exists in 40–52% of cases. We present a retrospective study of adjuvant radiotherapy (ART) in adverse pathological tumor characteristics of PCa, and analyze the optimal time for ART. Materials and methods: From 2004 to 2012, we identified 53 men with adverse pathological characteristics of PCa receiving early [< 3 months after radical prostatectomy (RP), n=42] or delayed (3–12 months after RP, n=11) ART after RP. The adverse pathological characteristics of PCa were defined as positive surgical margins, extracapsular extension, seminal-vesicle invasion, or detectable prostate-specific antigen after RP. The primary-outcome collection includes 5-year biochemical-free survival (BCFS), PCa-specific mortality, bone-related events, salvage-hormonal-therapy utilization, and intervention for urethral stricture. Results: There was no PCa-specific mortality in the 5-year follow-up. When compared with the delayed ART in men with adverse pathological characteristics of PCa, early ART was associated with the trend to improve the 5-year BCFS (89% vs. 73%; p=0.1) and less salvage hormonal therapy (45% vs. 54%; p=0.29). The delayed ART is associated with the trend of fewer urethral strictures (9% vs. 14 %; p=0.32). But, there was no significant difference between both groups. Conclusion: Compared with the delayed ART, early ART for adverse pathological tumor characteristics of PCa seems to have the trend in improvement in the 5-year BCFS and metastasis-free survival. Because of our limited case number, a prospective study with more cases to confirm the effect of ART is needed.

Keywords

• adjuvant radiotherapy
• delayed
• early
• prostate cancer
• prostatectomy