Results of early or delayed adjuvant radiotherapy for prostate cancer with adverse pathological tumor characteristics: A single-institute experience

Abstract

ObjectiveDespite an earlier detection of prostate cancer (Pca) is promising, pathologically advanced disease still exists in 40–52% of cases. We present a retrospective study of adjuvant radiotherapy (ART) in adverse pathological tumor characteristics of PCa, and analyze the optimal time for ART. Materials and methodsFrom 2004 to 2012, we identified 53 men with adverse pathological characteristics of PCa receiving early [< 3 months after radical prostatectomy (RP), n=42] or delayed (3–12 months after RP, n=11) ART after RP. The adverse pathological characteristics of PCa were defined as positive surgical margins, extracapsular extension, seminal-vesicle invasion, or detectable prostate-specific antigen after RP. The primary-outcome collection includes 5-year biochemical-free survival (BCFS), PCa-specific mortality, bone-related events, salvage-hormonal-therapy utilization, and intervention for urethral stricture. ResultsThere was no PCa-specific mortality in the 5-year follow-up. When compared with the delayed ART in men with adverse pathological characteristics of PCa, early ART was associated with the trend to improve the 5-year BCFS (89% vs. 73%; p=0.1) and less salvage hormonal therapy (45% vs. 54%; p=0.29). The delayed ART is associated with the trend of fewer urethral strictures (9% vs. 14 %; p=0.32). But, there was no significant difference between both groups. ConclusionCompared with the delayed ART, early ART for adverse pathological tumor characteristics of PCa seems to have the trend in improvement in the 5-year BCFS and metastasis-free survival. Because of our limited case number, a prospective study with more cases to confirm the effect of ART is needed.