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Erschienen in:

18.05.2023 | Original Article

Adverse risk factors for salvage radiotherapy outcomes after radical prostatectomy in prostate cancer patients

verfasst von: Halil Cumhur Yıldırım, Selvi Tabak Dinçer, Gökhan Yaprak, Nuri Kaydıhan, Ceren Barlas, Numan Çakıroğlu, Melike Pekyürek, Günay Can, Fazilet Öner Dinçbaş

Erschienen in: World Journal of Urology | Ausgabe 6/2023

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Abstract

Purpose

To investigate salvage treatment approaches and treatment outcomes in high-risk prostate cancer after radical prostatectomy (RP).

Methods

In this retrospective, multicenter study, 272 patients who underwent salvage radiotherapy (RT) ± androgen deprivation therapy (ADT) for recurrent prostate cancer after RP between 2007 and 2021 were analysed. Univariate analyses of time to biochemical and clinical relapse after salvage therapies were conducted using Kaplan–Meier plots and log-rank tests. Multivariate analyses were performed using a Cox proportional hazards model to determine the risk factors for disease relapse.

Results

Median age was 65 (48–82) years. All patients underwent salvage prostate bed RT. Pelvic lymphatic RT was performed in 66 patients (24.3%) and ADT was included in 158 (58.1%) patients. The median PSA value before RT was 0.35 ng/mL. The median follow-up time was 64 (12–180) months. 5-years bRFS, cRFS, and OS were 75.1%, 84.8%, and 94.9% respectively. In multivariate cox regression analysis; seminal vesicle invasion (HR 8.64, 95% CI 3.47–21.48, p < 0.001), pre-RT PSA higher than 0.14 ng/mL (HR 3.79, 95% CI 1.47–9.78, p = 0.006), and ≥ 2 positive pelvic lymph nodes (HR 2.50, 95% CI 1.11–5.62, p = 0.027) were found to be unfavorable prognostic factors for bRFS.

Conclusion

Salvage RT ± ADT provided 5-years biochemical disease control in 75.1% of patients. Seminal vesicle invasion, ≥ 2 positive pelvic nodes and delayed administration of salvage RT (PSA levels higher than 0.14 ng/mL) were found to be adverse risk factors for relapse. Such factors should be taken into account during the decision process on salvage treatment.

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Titel: Adverse risk factors for salvage radiotherapy outcomes after radical prostatectomy in prostate cancer patients
verfasst von: Halil Cumhur Yıldırım
Selvi Tabak Dinçer
Gökhan Yaprak
Nuri Kaydıhan
Ceren Barlas
Numan Çakıroğlu
Melike Pekyürek
Günay Can
Fazilet Öner Dinçbaş
Publikationsdatum: 18.05.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 6/2023
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-023-04419-7

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Adverse risk factors for salvage radiotherapy outcomes after radical prostatectomy in prostate cancer patients