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18.01.2017 | Original Article

Whole pelvis radiotherapy for pathological node-positive prostate cancer

Oncological outcome and prognostic factors

verfasst von: Dr. Filip Poelaert, MD, Valérie Fonteyne, MD PhD, Piet Ost, MD PhD, Bart De Troyer, MD, Karel Decaestecker, MD PhD, Gert De Meerleer, MD PhD, Pieter De Visschere, MD PhD, Tom Claeys, MD, Bert Dhondt, MD, Nicolaas Lumen, MD PhD

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 6/2017

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Abstract

Purpose

The goal of this work was to investigate the oncological outcome of whole pelvis radiotherapy (wpRT) in pathologic pelvic lymph node-positive (pN1) prostate cancer (PCa), evaluate the location of relapse, and identify potential prognostic factors.

Patients and methods

All patients undergoing pelvic lymph node dissection (PLND) since the year 2000 at a single tertiary care center were evaluated. A total of 154 patients with pN1 PCa were treated with wpRT (39 in an adjuvant setting) and 2–3 years of androgen deprivation therapy (ADT). Kaplan–Meier analysis was performed to estimate biochemical recurrence-free survival (bRFS), clinical progression-free survival (cPFS), and prostate cancer-specific survival (CSS). Uni- and multivariate regression analyses were performed to identify prognostic factors.

Results

Estimated bRFS was 67%, cPFS was 71%, and CSS was 96% at 5 years. Median follow-up was 55 months (interquartile range 25–87). Multivariate analysis identified having only 1 positive lymph node, a shorter time between diagnosis and PLND, and older age as independent favorable prognostic factors for biochemical and clinical recurrence. The number of positive lymph nodes was prognostic for CSS (hazard ratio [HR] 1.34, 95% confidence interval 1.17–1.54) and OS (HR 1.22, 95% confidence interval 1.10–1.36). Bone metastases were the most frequent location of PCa relapse (n = 32, 64%).

Conclusions

Patients with pN1 PCa treated with wpRT and 2–3 years ADT have an encouraging 5‑year CSS. Understaging of the disease extent may be the most important enemy in definitive pN1 PCa treatment.

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Titel: Whole pelvis radiotherapy for pathological node-positive prostate cancer
Oncological outcome and prognostic factors
verfasst von: Dr. Filip Poelaert, MD
Valérie Fonteyne, MD PhD
Piet Ost, MD PhD
Bart De Troyer, MD
Karel Decaestecker, MD PhD
Gert De Meerleer, MD PhD
Pieter De Visschere, MD PhD
Tom Claeys, MD
Bert Dhondt, MD
Nicolaas Lumen, MD PhD
Publikationsdatum: 18.01.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 6/2017
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-016-1094-5

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Whole pelvis radiotherapy for pathological node-positive prostate cancer

Oncological outcome and prognostic factors

Abstract

Purpose

Patients and methods

Results

Conclusions

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Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

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