Adjuvant Radiotherapy Following Radical Prostatectomy: Results and Complications

Gibbons, Robert P.; Cole, B. Sharon; Richardson, R. Garratt; Correa, Roy J.; Brannen, George E.; Mason, J. Tate; Taylor, Willis J.; Hafermann, Mark D.

doi:10.1007/978-1-4613-1667-1_13

Cited by 23 publications

(29 citation statements)

References 19 publications

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“…These results are consistent with other reported series (0-6%) [7,9,13,14,16,17,19]. Although Gibbons et al [24] reported some complications in up to a quarter of patients, most report 0-14% of mild to moderate RT-induced proctopathy [7,9,14,16,17,19,32,33]; nevertheless, the reported complication rate is relatively low and modest.…”

Section: Discussionsupporting

confidence: 90%

See 1 more Smart Citation

Predictive factors of radiation therapy for patients with prostate specific antigen recurrence after radical prostatectomy

Taille¹,

Flam²,

Thiounn³

et al. 2002

BJU International

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Objectives To assess the efficacy of salvage/adjuvant radiation therapy (RT) for patients with prostate-specific antigen (PSA) recurrence after radical prostatectomy (RP). Between 1997 and 2001, 52 patients were treated in our institution with RT for PSA recurrence after RP. The mean (range) delay between RP and RT was 30.5 (0.16-105.6) months. Eighteen patients received no hormonal therapy before RT. The failure of RT was defined as three consecutive increases in PSA levels with intervals of ≥ 6 weeks. Results Within a mean (range) follow-up of 27.7 (6-69) months, 18 patients presented with biochemical progression. The 3-year biochemical progression-free survival was 51%. Using univariate analysis, an age < 65 years ( P = 0.0262), a Gleason score on the RP specimen of ≥ 8 ( P = 0.0024), stage pT3 ( P = 0.02), a detectable nadir PSA after RT ( P < 0.001) and the absence of hormonal therapy ( P = 0.0359) were associated with a lower biochemical progression-free survival. However, only the Gleason score ( P = 0.0395) and nadir serum PSA after RT ( P = 0.028) remained independent predictive factors on multivariate analysis. Conclusion Half of the present patients treated with RT for an isolated high serum PSA level after RP were free of biochemical relapse at 3 years of follow-up. RT may be proposed to selected patients with mild morbidity. However, definitive evidence of the beneficial effect of adjuvant RT for patients with PSA recurrence after RP awaits the conclusion of randomized clinical trials. Patients and methods

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Section: Discussionsupporting

confidence: 90%

“…In some studies the risk of subsequent local recurrence was reduced substantially but there was no effect on distant metastases or cancer-specific survival [24]. Patients with seminal vesicle invasion typically recur with distant metastases [25].…”

Section: Discussionmentioning

confidence: 99%

Predictive factors of radiation therapy for patients with prostate specific antigen recurrence after radical prostatectomy

Taille¹,

Flam²,

Thiounn³

et al. 2002

BJU International

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“…99 However, with newer conformal and intensity modulated radiotherapy techniques the incidence of such complications is far lower. 101 Importantly there is no significant effect on urinary continence 105,106 or potency 107 following the administration of at leastn 45 -54 Gy of adjuvant radiotherapy.…”

Section: Adjuvant Treatment Options For Patients With Positive Surgicmentioning

confidence: 99%

“…99,117 Anti-androgens induce apoptosis in hormone sensitive prostate cancer cells irres-pective of their location. It is not surprising, therefore, that the risk of biochemical relapse is reduced, at least in the short-term, with androgen deprivation.…”

Section: Adjuvant Treatment Options For Patients With Positive Surgicmentioning

confidence: 99%

Avoidance and management of positive surgical margins before, during and after radical prostatectomy

Bott¹,

Kirby

2002

Prostate Cancer Prostatic Dis

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Positive surgical margins after radical prostatectomy lead to an increased risk of progression and reduced disease free survival. Earlier detection of prostate cancer, appropriate patient selection and improved operative techniques can reduce the incidence of positive margins, though the risk can not be eliminated as preoperative staging techniques are not sufficiently sensitive. Nerve sparing and bladder neck sparing do not adversely affect margin status in appropriately selected men. Once positive margins have been diagnosed the optimal management and the timing of treatment remains controversial. Adjuvant radiotherapy or salvage radiotherapy in men with a low PSA may improve local control and PSA free survival in some individuals, a survival benefit has not yet been established.

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“…Принимая во внимание, что результаты РПЭ до сих пор нельзя считать идеальными, определенная категория больных нуждается в адъювантной гормональной и луче-вой терапии, раннее проведение которых позволяет зна-чительно улучшить результаты лечения [9,10]. Поэтому остается актуальным выявление групп больных с высоким риском развития рецидива после радикального лечения для мультимодальной терапии, критерии идентификации которых не выработаны до настоящего времени.…”

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Molecular markers in the prediction of biochemically recurrent prostate cancer after radical surgery

Григоренко¹,

Romanenko²,

Bazalitskaya³

et al. 2014

Onkol. Z. im. P.A. Gercena

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Цель -изучить клиническое значение новых молекулярных маркеров erG, p27, Ki-67 в прогнозировании течения лока-лизованного рака предстательной железы (рпЖ). Материал и методы. из 208 больных, которым с 2002 по 2011 г. была выполнена радикальная простатэктомия, отобраны 44 больных локализованным рпЖ (т2n0M0), не получавших неоадъ-ювантной гормональной терапии. Каждые 3 мес после операции осуществляли контроль уровня сывороточного пСА. в исследуемую группу включены 16 больных с биохимически подтвержденным рецидивом рпЖ, в группу контроля вошли 28 больных без признаков рецидива заболевания. всем больным проводили иммуногистохимическое исследование опе-рационного материала для определения уровня экспрессии маркеров еrG, p27 и Ki-67. Результаты. положительная экс-прессия маркера erG была обнаружена у 20 пациентов и встречалась с одинаковой частотой в обеих группах -7 (48,8%) больных в исследуемой группе и 13 (46,4%) в группе контроля. Отмечено отсутствие экспрессии p27 у 4 (25,0%) больных с биохимическим рецидивом и у 6 (21,4%) без рецидива. Схожие результаты получены при сравнении больных со слабо и умеренно положительной реакцией: 5 (31,3%) больных в исследуемой группе против 8 (28,6%) в группе контроля. вы-сокая экспрессия р27+++ встречалась в 3 раза реже у больных исследуемой группы, чем у больных группы контроля -2 (12,5%) больных против 6 (21,4%). У больных с биохимическим рецидивом уровень экспрессии Ki-67 колебался в пределах 2,40-27,12, в среднем 11,46±1,57, в группе без рецидива данный показатель составлял 4,17-17,83, в среднем 8,36±0,73. Заключение. использование маркеров erG и р27 как высокоспецифичных маркеров прогноза рпЖ является сомнитель-ным, они требуют дальнейшего, более детального исследования. Отчетливая положительная реакция р27 может свидетель-ствовать о благоприятном прогнозе течения заболевания. Экспрессия маркера Ki-67, наряду с уровнем пСА и степенью дифференцировки опухоли по Глисону, является достоверным независимым прогностическим фактором рецидива рпЖ. Ключевые слова: рак предстательной железы, радикальное хирургическое лечение, биохимический рецидив, прогноз, молекулярные маркеры.Objective -to study the clinical value of the new molecular markers erG, p27, and Ki-67 in predicting the course of localized prostate cancer (pC). Material and methods. forty-four patients with localized pC (т2n0M0) who had not received neoadjuvant hormone therapy were selected from 208 patients who had undergone radical prostatectomy. Serum pSA levels were monitored every 3 months postsurgery. A study group included 16 patients with biochemically verified recurrent pC; a control group comprised 28 patients without signs of recurrence. intraoperative samples from all the patients were immunohistologically examined to estimate erG, p27, and Ki-67 expression levels. Results. A positive erG expression was detected in 20 patients and encountered with equal frequency in both groups: in 7 (48.8%) patients in the study group and 13 (46.4%) patients in the control group. no p27 expression was noted in 4 (25.0%) patien...

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Adjuvant Radiotherapy Following Radical Prostatectomy: Results and Complications

Cited by 23 publications

References 19 publications

Predictive factors of radiation therapy for patients with prostate specific antigen recurrence after radical prostatectomy

Predictive factors of radiation therapy for patients with prostate specific antigen recurrence after radical prostatectomy

Avoidance and management of positive surgical margins before, during and after radical prostatectomy

Molecular markers in the prediction of biochemically recurrent prostate cancer after radical surgery

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