Urology Medical News about pT3 prostate cancer;postoperative adjuvant radiotherapy;radical prostatectomy

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Phase III postoperative adjuvant radiotherapy after radical prostatectomy compared with radical prostatectomy alone in pT3 prostate cancer with postoperative undetectable prostate-specific antigen: ARO 96-02/AUO AP 09/95
Journal of Clinical Oncology, 05/13/09

Wiegel T et al. - In a study to compare radical prostatectomy (RP) followed by immediate radiotherapy (RT) with RP alone for pts with pT3 prostate cancer (PCa) and an undetectable prostate-specific antigen (PSA) level after RP, it was reported that adjuvant RT for pT3 PCa with postoperatively undetectable PSA significantly reduces the risk of biochemical progression.

Methods

After RP, 192 men were randomly assigned to a wait-and-see policy, and 193 men were assigned to immediate postoperative RT.
Eligible pts had pT3 pN0 tumors.
Pts who did not achieve an undetectable PSA after RP were excluded from treatment according to random assignment (n = 78; 20%).
34 of 307 pts on the RT arm did not receive RT and 5 pts on the wait-and-see arm received RT.
114 pts underwent RT and 154 pts were treated with a wait-and-see policy.
Primary endpoint was biochemical progression-free survival (PFS).

Results

Biochemical PFS after 5 yrs in pts with undetectable PSA after RP was significantly improved in the RT group (72% vs 54%).
On univariate analysis, Gleason score >6 and <7, PSA before RP, tumor stage, and positive surgical margins were predictors of outcome.
Rate of grade 3 to 4 late adverse effects was 0.3%.

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