MP62-17 PREDICTIVE FACTORS OF OUTCOME FOLLOWING SALVAGE RADIOTHERAPY ALONE FOR PATIENTS WITH BIOCHEMICAL RECURRENCE AFTER RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyProstate Cancer: Localized V1 Apr 2015MP62-17 PREDICTIVE FACTORS OF OUTCOME FOLLOWING SALVAGE RADIOTHERAPY ALONE FOR PATIENTS WITH BIOCHEMICAL RECURRENCE AFTER RADICAL PROSTATECTOMY Wan Song, Hwang Gyun Jeon, Hyun Hwan Sung, Deok Hyun Han, Joon Hyung Park, Young Hyo Choi, Sang Eun Lee, Byong Chang Jeong, Seong Il Seo, Seong Soo Jeon, Han Yong Choi, and Hyun Moo Lee Wan SongWan Song More articles by this author , Hwang Gyun JeonHwang Gyun Jeon More articles by this author , Hyun Hwan SungHyun Hwan Sung More articles by this author , Deok Hyun HanDeok Hyun Han More articles by this author , Joon Hyung ParkJoon Hyung Park More articles by this author , Young Hyo ChoiYoung Hyo Choi More articles by this author , Sang Eun LeeSang Eun Lee More articles by this author , Byong Chang JeongByong Chang Jeong More articles by this author , Seong Il SeoSeong Il Seo More articles by this author , Seong Soo JeonSeong Soo Jeon More articles by this author , Han Yong ChoiHan Yong Choi More articles by this author , and Hyun Moo LeeHyun Moo Lee More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2391AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In patient with biochemical recurrence (BCR) after radical prostatectomy (RP), salvage radiotherapy (SRT) is recommended as curative treatment option for patient with documented or presumed local recurrence. The aim of this study was to evaluate the oncologic outcomes of SRT and to investigate the predictive factors of SRT failure for patients with BCR after RP. METHODS We reviewed our prospectively maintained database of 2,043 patients who underwent RP at single institute between September 1995 and December 2011. Of the 297 (14.5%) patients with BCR defined as two consecutive serum prostate specific antigen (PSA) level of > 0.2ng/ml, 149 patients who received SRT and performed prostate magnetic resonance imaging (MRI) before SRT were included. Positive result in prostate MRI was defined when there is a high signal intensity lesion in T2 weighted image (T2WI) that is suspicious for local recurrence. Three-dimensional conformal RT (3D CRT) or intensity-modulated RT (IMRT) was delivered with median dose of 70.0Gy (66.0-78.0Gy) or 67.2Gy (64.8 - 70.0Gy). Treatment failure of SRT was defined as a serum PSA level of ¡Ý0.2ng/ml or as initiation of androgen-deprivation therapy (ADT). Kaplan-Meier and Cox regression analysis was carried out to investigate predictive factors of SRT failure RESULTS The mean age was 62.8 years with median follow up of 82 (20-153) months. The mean pre-operative and pre-SRT PSA were 10.48 ng/ml and 0.54 ng/ml, respectively. Pathologic stage ¡ÜpT2 was in 106 patients, Pathologic Gleason score ¡Ý7 was in 130 patients and positive surgical margin was in 47 patients. In prostate MRI, 97 patients showed positive results. Of 149 patients, 55 (36.9%) patients showed SRT failure. The 5 year SRT failure free probability was 53.6 %. By multivariate analysis, pre-SRT PSA ¡Ý1.0 (p = 0.003, hazard ratio [HR]: 3.657, 95% confidence interval [CI]: 1.570-8.517), pathologic stage ¡ÝT3a (p = 0.005, HR: 2.231, 95% CI: 1.278-3.896), pathologic Gleason score ¡Ý7 (p = 0.019, HR: 5.443, 95% CI: 1.320-22.443), and positive result in prostate MRI (p = 0.010, HR: 0.494, 95% CI: 0.289-0.843) were independent predictors of SRT failure after RP. CONCLUSIONS SRT provided excellent long term control of disease for patients with BCR after RP. Higher pre-SRT PSA, pathologic stage, pathologic Gleason score and negative result in prostate MRI are prognostic factors of SRT failure after RP © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e787 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Wan Song More articles by this author Hwang Gyun Jeon More articles by this author Hyun Hwan Sung More articles by this author Deok Hyun Han More articles by this author Joon Hyung Park More articles by this author Young Hyo Choi More articles by this author Sang Eun Lee More articles by this author Byong Chang Jeong More articles by this author Seong Il Seo More articles by this author Seong Soo Jeon More articles by this author Han Yong Choi More articles by this author Hyun Moo Lee More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...