Radical Prostatectomy in High-Grade Prostate Cancer, Salvage and Adjuvant Radiotherapy

Abstract

Introduction: Prostate cancer with a Gleason score (GS) of 8–10 is linked to a higher risk of recurrence and progression. The aim of this paper is to evaluate treatment results of our high-risk patient cohort.Patients and Methods: The cohort of 42 patients with radical prostatectomy (RP) specimen histology GS 8–10 was assessed. The patients were followed up after RP and radiotherapy (RT) was delivered in case of a biochemical relapse. Adjuvant radiotherapy (aRT) was delivered only in case of a positive surgical margin (PSM). The following parameters were evaluated: biochemical progression-free survival (BPFS), overall survival (OS) and cancer-specific survival (CSS). The second objective was to evaluate adverse effects of RP and RT. Results: The median follow-up time was 88 months (18–168). RP led to BPFS in 16 patients (38%). Five patients with PSM underwent aRT and 20 underwent salvage radiotherapy (sRT). One patient died of myocardial infarction and 1 patient died of metastatic disease. Skeletal metastases were recorded in 2 patients. The BPFS in RP combinations with sRT or aRT was reached in 29 patients (69%). The OS and CSS in our cohort reached 95 and 98%, respectively. Conclusion: Management with aRT only in PSM was very effective, according to our retrospective study.