Abstract
Adenocarcinoma of the prostate is a major health concern in the United States, with 31,620 deaths estimated for 2019. 1 Siegel RL Miller KD Jemal A Cancer statistics, 2019. CA Cancer J Clin. 2019; 69: 7-34 Crossref PubMed Scopus (13951) Google Scholar A recent population-based study of nearly 400,000 patients found that radical prostatectomy (RP) was the most commonly utilized treatment in the United States for intermediate- and high-risk patients. 2 Chen J Oromendia C Halpern JA Ballman KV National trends in management of localized prostate cancer: a population based analysis 2004-2013. Prostate. 2018; 78: 512-520 Crossref PubMed Scopus (35) Google Scholar In men under aged 70 in these risk groups, RP accounted for 48%-82% of first line therapy. 2 Chen J Oromendia C Halpern JA Ballman KV National trends in management of localized prostate cancer: a population based analysis 2004-2013. Prostate. 2018; 78: 512-520 Crossref PubMed Scopus (35) Google Scholar These patients with intermediate- and high-risk disease represent the population most to be at high risk for recurrence following RP, historically defined by the presence of extracapsular extension, seminal vesicle involvement, or positive surgical margins. The risk of subsequent biochemical failure in men with these adverse pathologic features ranges from 40% to 70%. 3 Bolla M van Poppel H Tombal B et al. Postoperative radiotherapy after radical prostatectomy for high-risk prostate cancer: long-term results of a randomised controlled trial (EORTC trial 22911). Lancet. 2012; 380: 2018-2027 Abstract Full Text Full Text PDF PubMed Scopus (637) Google Scholar , 4 Briganti A Wiegel T Joniau S et al. Early salvage radiation therapy does not compromise cancer control in patients with pT3N0 prostate cancer after radical prostatectomy: results of a match-controlled multi-institutional analysis. Eur Urol. 2012; 62: 472-487 Abstract Full Text Full Text PDF PubMed Scopus (137) Google Scholar , 5 Karakiewicz PI Eastham JA Graefen M et al. Prognostic impact of positive surgical margins in surgically treated prostate cancer: multi-institutional assessment of 5831 patients. Urology. 2005; 66: 1245-1250 Abstract Full Text Full Text PDF PubMed Scopus (241) Google Scholar , 6 Thompson Jr, IM Tangen CM Paradelo J et al. Adjuvant radiotherapy for pathologically advanced prostate cancer: a randomized clinical trial. JAMA. 2006; 296: 2329-2335 Crossref PubMed Scopus (799) Google Scholar , 7 Wiegel T Bartkowiak D Bottke D et al. Adjuvant radiotherapy versus wait-and-see after radical prostatectomy: 10-year follow-up of the ARO 96-02/AUO AP 09/95 trial. Eur Urol. 2014; 66: 243-250 Abstract Full Text Full Text PDF PubMed Scopus (308) Google Scholar
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