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International Journal of Clinical Oncology

, Volume 24, Issue 10, pp 1238–1246 | Cite as

Time to biochemical relapse after radical prostatectomy and efficacy of salvage radiotherapy in patients with prostate cancer

  • Sahyun Pak
  • Dalsan You
  • In Gab Jeong
  • Young Seok Kim
  • Jun Hyuk Hong
  • Choung-Soo Kim
  • Hanjong AhnEmail author
Original Article
  • 146 Downloads

Abstract

Background

To investigate the prognostic and therapeutic implications of time to biochemical relapse (BCR) in patients with prostate cancer after radical prostatectomy.

Methods

The records of 3210 consecutive men with prostate cancer who underwent radical prostatectomy between January 1998 and June 2013 were retrospectively reviewed. Patients with BCR were divided into three groups based on quartiles of time to BCR, namely an early group (first quartile), an intermediate group (second and third quartiles) and late group (fourth quartile).

Results

817 (25.5%) patients experienced BCR at a median of 24.9 months after surgery. The 8-year rate of distant metastasis-free survival (64.3% vs. 41.3%, p = 0.002) and cancer-specific survival (86.6% vs. 63.4%, p < 0.001) was higher in the salvage radiotherapy (SRT) group than the androgen deprivation therapy (ADT) group in patients with early BCR, whereas those rates (91.3% vs. 87.9%, p = 0.607 and 100.0% vs. 93.1%, p = 0.144, respectively) were similar in patients with late BCR. In the intermediate BCR group, the impact of SRT over ADT on 8-year cancer-specific survival was modest (91.9% vs. 82.3%, p = 0.057) and was limited to patients with pT2 or pT3a disease.

Conclusions

SRT may decrease the risk of distant metastasis and cancer-specific mortality in patients with early BCR. However, a survival benefit for those with late BCR was not apparent. For patients with intermediate BCR, SRT was associated with a cancer-specific survival benefit in patients with pT2 or pT3a disease. Novel genomic tests and imaging modalities may support clinical decision-making in these patients.

Keywords

Prostatic neoplasm Prostatectomy Radiotherapy Survival 

Notes

Funding

There were no sources of funding for this study.

Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest to declare.

Supplementary material

10147_2019_1463_MOESM1_ESM.jpg (110 kb)
Supplementary Figure 1. Kaplan-Meier analysis of A) distant metastasis-free, B) cancer-specific survival, and C) overall survival as a function of additional biochemical relapse-free survival time after surgery. (JPG 110 kb)
10147_2019_1463_MOESM2_ESM.jpg (85 kb)
Supplementary Figure 2. Kaplan-Meier analyses of cancer-specific survival based on salvage treatments and prostate-specific antigen doubling time. A) Prostate-specific antigen doubling time < 3 months, B) Prostate-specific antigen doubling time ≥ 3 months. (JPG 84 kb)

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Copyright information

© Japan Society of Clinical Oncology 2019

Authors and Affiliations

  • Sahyun Pak
    • 1
  • Dalsan You
    • 2
  • In Gab Jeong
    • 2
  • Young Seok Kim
    • 3
  • Jun Hyuk Hong
    • 2
  • Choung-Soo Kim
    • 2
  • Hanjong Ahn
    • 2
    Email author
  1. 1.Department of Urology, Center for Urologic CancerNational Cancer CenterGoyangSouth Korea
  2. 2.Department of UrologyUniversity of Ulsan College of Medicine, Asan Medical CenterSeoulSouth Korea
  3. 3.Department of Radiation OncologyUniversity of Ulsan College of Medicine, Asan Medical CenterSeoulSouth Korea

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