TY - JOUR
T1 - Pathologic seminal vesicle invasion after radical prostatectomy for patients with prostate carcinoma
T2 - Effect of early adjuvant radiation therapy on biochemical control
AU - Valicenti, Richard K
AU - Gomella, Leonard G.
AU - Ismail, Mohammed
AU - Mullholland, S. Grant
AU - Petersen, Robert O.
AU - Corn, Benjamin W.
PY - 1998/5/15
Y1 - 1998/5/15
N2 - BACKGROUND. The authors evaluated the effect of postoperative radiation therapy on freedom from biochemical failure (bNED) in men with prostate carcinoma who had pathologic seminal vesicle invasion after radical prostatectomy and negative pelvic lymph node dissection (pT3cN0). METHODS. Between 1989 and 1995, 375 men underwent radical prostatectomy at Thomas Jefferson University Hospital. Fifty-three men (13%) had pT3cN0 prostate carcinoma and were the subject of this analysis. Men in whom prostate specific antigen (PSA) could not be detected were deemed free of biochemical failure. RESULTS. Of the 53 men with pT3cNO prostate carcinoma, 18 had an elevated PSA immediately after surgery and received salvage radiation therapy (RT). The 3-year bNED rate for this group was only 38%. At 3 months, PSA could not be detected in the other 35 men. Fifteen of those 35 men underwent early adjuvant RT, and the other 20 were observed for biochemical failure. The 3-year bNED rate for the 15 patients treated with immediate adjuvant RT was 86%, compared with 48% for the 20 men who were observed (P = 0.01). CONCLUSIONS. These data suggest that early adjuvant RT for men with pT3cN0 prostate carcinoma and no detectable PSA postoperatively reduces the likelihood of future biochemical failure. Men with pT3cN0 prostate carcinoma and a persistently elevated postoperative PSA level are less likely to benefit from RT and should be considered for systemic therapy.
AB - BACKGROUND. The authors evaluated the effect of postoperative radiation therapy on freedom from biochemical failure (bNED) in men with prostate carcinoma who had pathologic seminal vesicle invasion after radical prostatectomy and negative pelvic lymph node dissection (pT3cN0). METHODS. Between 1989 and 1995, 375 men underwent radical prostatectomy at Thomas Jefferson University Hospital. Fifty-three men (13%) had pT3cN0 prostate carcinoma and were the subject of this analysis. Men in whom prostate specific antigen (PSA) could not be detected were deemed free of biochemical failure. RESULTS. Of the 53 men with pT3cNO prostate carcinoma, 18 had an elevated PSA immediately after surgery and received salvage radiation therapy (RT). The 3-year bNED rate for this group was only 38%. At 3 months, PSA could not be detected in the other 35 men. Fifteen of those 35 men underwent early adjuvant RT, and the other 20 were observed for biochemical failure. The 3-year bNED rate for the 15 patients treated with immediate adjuvant RT was 86%, compared with 48% for the 20 men who were observed (P = 0.01). CONCLUSIONS. These data suggest that early adjuvant RT for men with pT3cN0 prostate carcinoma and no detectable PSA postoperatively reduces the likelihood of future biochemical failure. Men with pT3cN0 prostate carcinoma and a persistently elevated postoperative PSA level are less likely to benefit from RT and should be considered for systemic therapy.
KW - Prostate carcinoma
KW - Prostate specific antigen
KW - Radiation therapy
KW - Seminal vesicle invasion
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U2 - 10.1002/(SICI)1097-0142(19980515)82:10<1909::AID-CNCR14>3.0.CO;2-X
DO - 10.1002/(SICI)1097-0142(19980515)82:10<1909::AID-CNCR14>3.0.CO;2-X
M3 - Article
C2 - 9587124
AN - SCOPUS:0032525171
VL - 82
SP - 1909
EP - 1914
JO - Cancer
JF - Cancer
SN - 0008-543X
IS - 10
ER -