Adjuvant radiotherapy or early salvage radiotherapy in pT3R0 or pT3R1 prostate cancer

Bartkowiak, Detlef; Bottke, Dirk; Wiegel, Thomas

doi:10.1097/mou.0b013e328361d3ed

Cited by 6 publications

(6 citation statements)

References 72 publications

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“…Single-modality therapy involving surgery alone might be of limited use in patients with stage pT3N0M0 prostate cancer, and a multimodal approach may be more beneficial. Three studies found that adjuvant radiotherapy after radical prostatectomy reduced the risk of subsequent biochemical recurrence in randomized clinical trials [5-7]. Thompson et al reported a survival benefit of adjuvant radiotherapy, with a 10-year estimated survival rate of 74% in 214 patients with pT2-3 N0 prostate cancer treated with adjuvant radiotherapy, compared with 66% in 211 cases treated with surgery alone, after median follow-up period of 12.5 years [5,6].…”

Section: Discussionmentioning

confidence: 99%

Long-term results of radical prostatectomy with immediate adjuvant androgen deprivation therapy for pT3N0 prostate cancer

et al. 2014

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BackgroundRadical prostatectomy is used to treat patients with clinically localized prostate cancer, but there have been few reports of its use in locally advanced disease. We evaluated the long-term results of radical prostatectomy and immediate adjuvant androgen deprivation therapy in Japanese patients with pT3N0M0 prostate cancer.MethodsWe retrospectively reviewed 128 patients with pT3N0M0 prostate cancer who underwent radical prostatectomy at our institute from 2000 to 2006. All pT3N0 patients were treated with adjuvant androgen deprivation therapy shortly after radical prostatectomy. Immediate adjuvant androgen deprivation therapy was continued for at least 5 years. Twenty-three were excluded because of preoperative hormonal therapy, missing data, or others. Death from any cause, death from prostate cancer, clinical recurrence and hormone-refractory biochemical progression were analyzed by Kaplan-Meier graphs. Relative risks of progression were estimated using Cox proportional hazards models with 95% confidence intervals.ResultsThe 10-year hormone-refractory biochemical progression-free survival rate was 88.3% and the cancer-specific survival rate was 96.3% after a median follow-up period of 8.2 years (range 25.6-155.6 months). Higher clinical stage (p = 0.013), higher Gleason score at biopsy (p = 0.001), seminal vesicle invasion (p = 0.003) and microlymphatic invasion (p = 0.006) were predictive factors for hormone-refractory biochemical progression by univariate analyses. Multivariate analyses identified Gleason score at biopsy (p = 0.027) and seminal vesicle invasion (p = 0.030) as independent prognostic factors for hormone-refractory biochemical progression. None of the patients with clinical T1 cancers (n = 20), negative surgical margin (n = 12), or negative perineural invasion (n = 11) experienced hormone-refractory biochemical progression.ConclusionsRadical prostatectomy with immediate adjuvant androgen deprivation therapy may be a valid treatment option for patients with pT3N0M0 prostate cancer.

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Section: Discussionmentioning

confidence: 99%

Long-term results of radical prostatectomy with immediate adjuvant androgen deprivation therapy for pT3N0 prostate cancer

et al. 2014

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“…1800 hastanın dahil edildiği 3 randomize prospektif çalışmanın analizinde, cerrahi sınır pozitifliği olan hastalarda, cerrahi sonrası adjuvan RT ile tedavinin hastanın cerrahi sonrası aktif takibe alınması ile arasında klinik ve istatistiksel açıdan üstünlüğü olduğu kadar yan etki profili açısından da daha fazla zararı olduğu gösterildi (29,30). Rektal komplikasyonlar, üretral darlık ve total üriner inkontinans oranları sadece cerrahi tedavi alan ve sadece takip olanlara nispeten daha fazlaydı.…”

Section: Adjuvan Rtunclassified

Patoloji̇k T3 Evre Prostat Kanseri̇nde Cerrahi̇ Sinir Pozi̇ti̇fli̇ği̇ Ve Radyoterapi̇

Gözükara¹,

Davarci²,

Görür³

2014

Mustafa Kemal Üniversitesi Tıp Dergisi

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Prostat kanseri erkeklerde en sık görülen solid kanser türüdür ve tanı aldığında %91'i prostata sınırlıdır. Daha az görülen organ dışına yayılım, cerrahi sonrası, cerrahi sınır pozitifliği gibi riskleri de beraberinde getirmektedir. Cerrahi sonrası patoloji spesimeninde saptanan cerrahi sınır pozitifliği olan hastalarda tedavide radyoterapi (RT) çok önemli bir yer tutmaktadır. Bu derleme, radyoterapinin cerrahi sınır pozitifliği olan prostat kanserli hastalardaki yeri ve yapılmış çalışmalar hakkında bilgiler içermektedir.

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“…La radioterapia di salvataggio (SRT) apre una seconda possibilità di cura per la recidiva locale e per i pazienti con PSA rilevabile dopo chirurgia: oltre il 60% può riportarsi ad un PSA nel range di normalità (65–68) e l'80% può essere libero da progressione a 5 anni (67): valori di PSA pre-RT inferiori a 0,5 ng/mL sono associati con una sopravvivenza libera da recidiva significativamente superiore (66, 69). Studi clinici prospettici randomizzati, in corso, RADICALS (70), GETUG-17/0702 (71) e RAVES TROG 08-03 (72), confrontano ART e SRT considerando anche il beneficio aggiuntivo dalla terapia ormonale: essi contribuiranno a chiarire l'impatto della radioterapia adiuvante rispetto al salvataggio, il valore relativo della combinazione RT-terapie ormonali, e a rendere chiaro quali pazienti ne trarranno beneficio (49).…”

Section: Indicazioniunclassified

“…Le tecnologie a disposizione, infine, dovrebbero consentire un'ulteriore riduzione degli effetti collaterali, peraltro già contenuti (65, 77), anche con dosi decisamente superiori ai 70 Gy (78, 79).…”

Section: Indicazioniunclassified

La Radioterapia Nel Trattamento Del Carcinoma Della Prostata: Indicazioni, Evoluzione Tecnologica e Approcci Integrati

et al. 2013

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Prostate cancer is a heterogeneous, indolent or sometimes aggressive tumor. Treatment options are various and without proved superiority. Radiotherapy (RT) plays a key role in the disease history. Technological evolution with Intensity Modulate Radiation Therapy (IMRT) and Image Guided Radiation Therapy (IGRT) allowed improvement, with significant results on local control and survival. Hypofractionation, Stereotactic Body RT (SBRT) and new brachytherapy approachs are still under investigation, with promising opportunities. Adjuvant vs salvage postoperative RT, hormone association, prophylactic pelvic irradiation are still under debate, but guidelines express overlapping indications. Multidisciplinary managements will be the future for care optimization, providing the best tool for  holistic and informed patients’ choice.

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Adjuvant radiotherapy or early salvage radiotherapy in pT3R0 or pT3R1 prostate cancer

Cited by 6 publications

References 72 publications

Long-term results of radical prostatectomy with immediate adjuvant androgen deprivation therapy for pT3N0 prostate cancer

Long-term results of radical prostatectomy with immediate adjuvant androgen deprivation therapy for pT3N0 prostate cancer

Patoloji̇k T3 Evre Prostat Kanseri̇nde Cerrahi̇ Sinir Pozi̇ti̇fli̇ği̇ Ve Radyoterapi̇

La Radioterapia Nel Trattamento Del Carcinoma Della Prostata: Indicazioni, Evoluzione Tecnologica e Approcci Integrati

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