947 RADIOTHERAPY FOLLOWING PROSTATECTOMY DOES NOT IMPACT BONE-RELATED EVENTS IN PATIENTS WITH NODE-POSITIVE PROSTATE CANCER

Abstract

You have accessJournal of UrologyProstate Cancer: Advanced III1 Apr 2012947 RADIOTHERAPY FOLLOWING PROSTATECTOMY DOES NOT IMPACT BONE-RELATED EVENTS IN PATIENTS WITH NODE-POSITIVE PROSTATE CANCER Joshua Kaplan, Keith Kowalczyk, Tudor Borza, Xiangmei Gu, Paul Nguyen, Hua-Yin Yu, and Jim Hu Joshua KaplanJoshua Kaplan Boston, MA More articles by this author , Keith KowalczykKeith Kowalczyk Washington, DC More articles by this author , Tudor BorzaTudor Borza Boston, MA More articles by this author , Xiangmei GuXiangmei Gu Boston, MA More articles by this author , Paul NguyenPaul Nguyen Boston, MA More articles by this author , Hua-Yin YuHua-Yin Yu Boston, MA More articles by this author , and Jim HuJim Hu Boston, MA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1045AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Retrospective data suggests that adjuvant radiation therapy (ART) following radical prostatectomy (RP) for men with lymph node positive prostate cancer is beneficial in terms of biochemical recurrence (BCR) and cancer-specific survival. ART has also been associated with fewer bone-related events (BRE) in patients with locally advanced prostate cancer, however it is unknown if this benefit extends to men with lymph node positive disease. Using a population-based approach, we assessed the impact of ART in men with lymph node positive disease following RP. METHODS Using SEER-Medicare linked data, we identified 577 men with lymph node positive prostate cancer following RP from 1995-2007. We further identified those who received postoperative ART (n=177) and those who did not (n=400) within one year of surgery. All men with metastatic disease (other than lymph node involvment) were excluded. All baseline demographic and pathologic data were compared, including utilization of postoperative androgen deprivation therapy (ADT). Propensity-score methods were used to balance baseline demographic and pathologic data. Overall mortality (OM), prostate cancer-specific mortality (PCSM) and BRE (defined as bone metastasis or pathologic fracture) rates were measured and compared. RESULTS Men receiving ART had higher rates of ADT utilization. There was no differences in lymph node density between the two groups. There were no significant differences in overall mortality (5.09 vs. 3.76 events per 100 person-years, p=0.153), cancer-specific mortality (2.83 vs. 1.28, p=0.089), or BRE (4.13 vs. 4.20 events per 100 person-years, p=0.945) between the two groups, regardless of pathologic stage. CONCLUSIONS Although previous retrospective data has indicated that ART may have survival and BCR benefits in men with lymph node positive prostate cancer following RP, we did not find any significant benefit using a population based approach. Additionally, we did not find a decrease of BRE in men undergoing ART vs. no ART. Utilization of ART following RP for lymph-node positive disease may have a negative impact on patient quality of life as well as health care costs despite lack of clear benefit. Further prospective studies are needed to clarify the role of ART in these men. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e385 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Joshua Kaplan Boston, MA More articles by this author Keith Kowalczyk Washington, DC More articles by this author Tudor Borza Boston, MA More articles by this author Xiangmei Gu Boston, MA More articles by this author Paul Nguyen Boston, MA More articles by this author Hua-Yin Yu Boston, MA More articles by this author Jim Hu Boston, MA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...