PD27-08 PREDICTORS OF EARLY FAILURE AFTER TIMELY ADMINISTERED SALVAGE RADIOTHERAPY FOR BIOCHEMICAL RECURRENCE AFTER RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyProstate Cancer: Advanced I1 Apr 2014PD27-08 PREDICTORS OF EARLY FAILURE AFTER TIMELY ADMINISTERED SALVAGE RADIOTHERAPY FOR BIOCHEMICAL RECURRENCE AFTER RADICAL PROSTATECTOMY Giorgio Gandaglia, Steven Joniau, Cesare Cozzarini, Maxine Sun, Bertrand Tombal, Karin Haustermans, Wolfgang Hinkelbein, Shahrokh F. Shariat, Pierre I. Karakiewicz, Hein Van Poppel, Thomas Wiegel, Francesco Montorsi, and Alberto Briganti Giorgio GandagliaGiorgio Gandaglia More articles by this author , Steven JoniauSteven Joniau More articles by this author , Cesare CozzariniCesare Cozzarini More articles by this author , Maxine SunMaxine Sun More articles by this author , Bertrand TombalBertrand Tombal More articles by this author , Karin HaustermansKarin Haustermans More articles by this author , Wolfgang HinkelbeinWolfgang Hinkelbein More articles by this author , Shahrokh F. ShariatShahrokh F. Shariat More articles by this author , Pierre I. KarakiewiczPierre I. Karakiewicz More articles by this author , Hein Van PoppelHein Van Poppel More articles by this author , Thomas WiegelThomas Wiegel More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , and Alberto BrigantiAlberto Briganti More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2107AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Although previous studies evaluated the efficacy of early salvage radiotherapy (eSRT) in prostate cancer (PCa) patients experiencing biochemical recurrence (BCR) after radical prostatectomy (RP), none of them identified the predictors of early treatment failure in these patients. The aim of our study was to assess predictive factors associated with early failure of eSRT given for BCR. METHODS Using a multi-institutional cohort, 472 patients who received eSRT for BCR after RP between 1993 and 2009 were identified. All patients had histologically confirmed pT2/pT3, R0–R1, pN0 disease at RP and undetectable PSA values (<0.1 ng/ml) after surgery. No patient received neo-adjuvant or concomitant/adjuvant hormonal therapy. Early SRT was defined as local radiation to the prostate and seminal vesicle bed delivered at a PSA ≤0.5ng/ml. Early treatment failure was defined as BCR (PSA>0.2 ng/ml) within 2 months after eSRT. Univariable and multivariable regression analyses were performed to test the association between patient characteristics at radiotherapy (surgical margin status, pathological Gleason score, tumor stage, radiotherapy dose, time from surgery to eSRT, and PSA at radiotherapy) and treatment failure after eSRT. RESULTS Mean patient age was 62.3 years (median: 63). Median PSA at sRT was 0.24 ng/ml (IQR:0.13-0.35 ng/ml). Median dose of sRT was 67.9 (IQR: 66.6-70.2). Overall, 25 (5.3%) patients experienced early treatment failure after eSRT. At univariable analyses, surgical margins, pathological Gleason score, and radiotherapy dose were associated with higher risk of detectable PSA levels after treatment. Particularly, patients with positive surgical margins had 3.4-fold higher risk of having detectable PSA after eSRT compared to those with negative margins (P=0.01). Similarly, men with pathological Gleason score 8-10 had 3.7-fold higher probability of experiencing treatment failure compared to their counterparts with Gleason score 2-7 (P=0.01). Finally, lower radiotherapy dose was associated with higher risk of treatment failure (P=0.005). These observations were confirmed at multivariable analysis (all P≤0.04). CONCLUSIONS Positive surgical margins at RP, pathological Gleason score 8-10, and lower dose of radiotherapy represent independent predictors of treatment failure after eSRT. These parameters should be used to identify patients who might benefit from concomitant systemic treatment administration at time of eSRT and/or whole-pelvis radiotherapy in the context of a multimodal salvage approach. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e767 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Giorgio Gandaglia More articles by this author Steven Joniau More articles by this author Cesare Cozzarini More articles by this author Maxine Sun More articles by this author Bertrand Tombal More articles by this author Karin Haustermans More articles by this author Wolfgang Hinkelbein More articles by this author Shahrokh F. Shariat More articles by this author Pierre I. Karakiewicz More articles by this author Hein Van Poppel More articles by this author Thomas Wiegel More articles by this author Francesco Montorsi More articles by this author Alberto Briganti More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...