You have accessJournal of UrologyProstate Cancer: Localized: Radiation Therapy1 Apr 2016MP14-06 THE IMPACT OF ADJUVANT RADIOTHERAPY ON CANCER-SPECIFIC MORTALITY IN PROSTATE CANCER PATIENTS WITH SEMINAL VESICLE INVOLVEMENT: A COMPETING-RISKS REGRESSION ANALYSIS Giorgio Gandaglia, Nicola Fossati, Marco Bianchi, Paolo Dell’Oglio, Marta Picozzi, Elena Farina, Renzo Colombo, Umberto Capitanio, Emanuele Zaffuto, Walter Cazzaniga, Stefano Luzzago, Cesare Cozzarini, Francesco Montorsi, and Alberto Briganti Giorgio GandagliaGiorgio Gandaglia More articles by this author , Nicola FossatiNicola Fossati More articles by this author , Marco BianchiMarco Bianchi More articles by this author , Paolo Dell’OglioPaolo Dell’Oglio More articles by this author , Marta PicozziMarta Picozzi More articles by this author , Elena FarinaElena Farina More articles by this author , Renzo ColomboRenzo Colombo More articles by this author , Umberto CapitanioUmberto Capitanio More articles by this author , Emanuele ZaffutoEmanuele Zaffuto More articles by this author , Walter CazzanigaWalter Cazzaniga More articles by this author , Stefano LuzzagoStefano Luzzago More articles by this author , Cesare CozzariniCesare Cozzarini 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.2016.02.2509AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Prostate cancer (PCa) patients with seminal vesicle invasion (SVI) are at increased risk of recurrence and mortality after radical prostatectomy (RP). We aimed at assessing the impact of adjuvant radiotherapy (aRT) on cancer-specific mortality (CSM) in patients with SVI after adjusting for the risk of dying from other causes METHODS A total of 1,218 patients with localized PCa undergoing RP at a single center between 1990 and 2015 were identified. All patients included in the study had SVI at final pathology. Cumulative incidence CSM rates were generated for the overall population and after stratifying patients according to aRT status and were compared using the Gray test. Competing-risks regression analyses assessed the impact of aRT on CSM after adjusting for the risk of dying from other causes. Covariates consisted of age, positive surgical margins, pathologic Gleason score, adjuvant hormonal therapies, and nodal status RESULTS Median age was 66.4 years. Overall, 10.5, 42.3, and 47.2% of the patients included had pathologic Gleason score ≤6, 7, and ≥8, respectively. Overall, 539 (44.3%) patients had positive surgical margins. Overall, 641 (52.6%) patients had node positive disease. Median follow-up was 84 months. Overall, 222 patients experienced clinical recurrence (CR). The 15-year CR-free survival rate was 55.5%. Among patients who experienced CR, 19.7, 20.7, 8.0, and 51.6% had involvement of the prostatic fossa, pelvic lymph nodes, retroperitoneal nodes, and systemic metastases. Overall, 98 and 110 patients died from PCa and other causes, respectively. Overall, the 15-year CSM rate was 18.8%. When patients were stratified according to aRT status, the 15-year CSM rates were significantly higher among those who did not receive aRT as compared to those treated with aRT (22.9 vs. 13.7%, respectively; P=0.02). In competing-risks regression analyses, aRT (Hazard ratio [HR]: 0.51; P=0.01), pathologic Gleason score 8-10 (HR: 2.36; P=0.01); and pN1 (HR: 1.79; P=0.02) represented independent predictors of CSM CONCLUSIONS A substantial proportion of patients with SVI is at risk of experiencing systemic recurrence after surgery. Adjuvant RT significantly reduced the risk of CSM after accounting for the risk of dying from other causes. These results suggest that maximising local control would improve oncologic outcomes in these patients. Conversely, men with node positive disease and higher Gleason score are at higher risk of CSM and might benefit more from systemic approaches © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e145 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Giorgio Gandaglia More articles by this author Nicola Fossati More articles by this author Marco Bianchi More articles by this author Paolo Dell’Oglio More articles by this author Marta Picozzi More articles by this author Elena Farina More articles by this author Renzo Colombo More articles by this author Umberto Capitanio More articles by this author Emanuele Zaffuto More articles by this author Walter Cazzaniga More articles by this author Stefano Luzzago More articles by this author Cesare Cozzarini 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 ...