Urology Medical News about postoperative adjuvant dariotherapy;darical prostatectomy;pT3 prostate cancer

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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, 06/22/09

Wiegel T et al. - Adjuvant radiotherapy (RT) for pT3 prostate cancer with postoperatively undetectable PSA significantly reduces the risk of biochemical progression. Further follow-up is needed to assess the effect on metastases-free and overall survival.

Methods

Study to compare radical prostatectomy (RP) followed by immediate RT for pts with pT3 PCa and an undetectable PSA after RP
Eligible pts had pT3 pN0 tumors; after RP:
- 192 men were randomly assigned to a wait-and-see policy, and
- 193 men were assigned to immediate postoperative RT
Pts who did not achieve an undetectable PSA after RP were excluded
Of the remaining 307 pts, 34 pts on the RT arm did not receive RT and 5 pts on the wait-and-see arm received RT
Therefore, 114 pts underwent RT and 154 pts were treated with a wait-and-see policy
The primary end point: 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
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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