To retrospectively evaluate the role of adjuvant radiotherapy (ART) as monotherapy in a cohort of prostate cancer patients with undetectable prostate-specific antigen (PSA) after surgery and to propose a risk stratification system.
Between 2003 and 2010, 174 consecutive patients were treated with ART (median dose 71 Gy) at a single institution. Subsequently, we assigned a score of 1 to the following risk factors (RF): T stage ≥3b, presurgical PSA ≥10 ng/mL, pathologic Gleason score (GS) ≥4 + 3, and positive surgical margin (R1). The scores were then summed to stratify the population into low risk (LR), intermediate risk (IR), and high risk (HR).
Median follow-up was 61 months (range 4-105). Five-year biochemical relapse-free survival (bRFS), clinical relapse-free survival (cRFS), and overall survival (OS) were respectively 93%, 97.1%, and 98.6%. On univariate analyses, GS was the only variable related to bRFS (p = 0.04) and to cRFS (p = 0.05). Any variable was related to OS. Kaplan-Meier analysis showed that HR patients (3-4 RF) had a worse bRFS (p = 0.02) compared to LR patients (0 RF or R1 as single RF); IR patients (1-2 RF) had a lower bRFS compared to LR patients (p = 0.06). Patients with R1 as single RF have the same bRFS as patients with 0 RF (p = 0.6) and are considered as LR patients.
Adjuvant radiotherapy leads to excellent bRFS and cRFS rates at 5 years (93.3% and 97.1%, respectively) in our population. Patients with multiple RF are at higher risk of bRFS. Patients with R1 as single RF have bRFS rates comparable to patients without any RF.
Tumori 2016; 102(3): 323 - 329
Article Type: ORIGINAL RESEARCH ARTICLE
AuthorsMario Levis, Alessia Guarneri, Niccolò Giaj Levra, Daniel E. Spratt, Sara Bartoncini, Fernando Munoz, Elisabetta Trino, Angela Botticella, Francesca Arcadipane, Umberto Ricardi
- • Accepted on 16/02/2016
- • Available online on 22/03/2016
- • Published in print on 02/06/2016
This article is available as full text PDF.
- Levis, Mario [PubMed] [Google Scholar] 1, * Corresponding Author (email@example.com)
- Guarneri, Alessia [PubMed] [Google Scholar] 2
- Giaj Levra, Niccolò [PubMed] [Google Scholar] 1, *
- Spratt, Daniel E. [PubMed] [Google Scholar] 3, §
- Bartoncini, Sara [PubMed] [Google Scholar] 1
- Munoz, Fernando [PubMed] [Google Scholar] 2, ¶
- Trino, Elisabetta [PubMed] [Google Scholar] 1
- Botticella, Angela [PubMed] [Google Scholar] 1, #
- Arcadipane, Francesca [PubMed] [Google Scholar] 1
- Ricardi, Umberto [PubMed] [Google Scholar] 1
Department of Oncology, Radiation Oncology, University of Turin, Turin - Italy
Radiation Oncology, AOU City of the Health and of the Science, Turin, Turin - Italy
Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY - USA
Present address: Radiation Oncology, Sacro Cuore-Don Calabria Hospital, Negrar-Verona - Italy
Present address: Radiation Oncology, University Hospitals Leuven/KU Leuven, Leuven - Belgium
Present address: Department of Radiation Oncology, University of Michigan, Ann Arbor, MI - USA
Present address: Radiation Oncology, Tomotherapy Unit, Regional Hospital U. Parini, Aosta - Italy