Outcome, morbidity, and prognostic factors in post-prostatectomy radiotherapy: An Australian multicenter study

Duchesne, Gillian M., Dowling, Caroline, Frydenberg, Mark, Joseph, David, Gogna, N. Kumar, Neerhut, Greg, Roberts, Sydney, Spry, Nigel, Turner, Sandra and Woo, Henry (2003) Outcome, morbidity, and prognostic factors in post-prostatectomy radiotherapy: An Australian multicenter study. Urology, 61 1: 179-183. doi:10.1016/S0090-4295(02)02005-8


Author Duchesne, Gillian M.
Dowling, Caroline
Frydenberg, Mark
Joseph, David
Gogna, N. Kumar
Neerhut, Greg
Roberts, Sydney
Spry, Nigel
Turner, Sandra
Woo, Henry
Title Outcome, morbidity, and prognostic factors in post-prostatectomy radiotherapy: An Australian multicenter study
Journal name Urology   Check publisher's open access policy
ISSN 0090-4295
1527-9995
Publication date 2003-01
Sub-type Article (original research)
DOI 10.1016/S0090-4295(02)02005-8
Volume 61
Issue 1
Start page 179
End page 183
Total pages 5
Place of publication New York, NY, U.S.A.
Publisher Excerpta Medica, Inc.
Language eng
Subject 1103 Clinical Sciences
Formatted abstract
Objectives
To report the outcome and morbidity data for patients treated with post-prostatectomy radiotherapy (PPRT) in a multicenter collaboration.

Methods
The case records of all patients treated with PPRT from 1996 to 1998 were reviewed. Survival was calculated using Kaplan-Meier methods. Potential prognostic factors were evaluated using the Cox proportional hazards regression model. Prostate-specific antigen (PSA) remission was defined as a PSA level of 0.2 ng/mL or less. Acute and late morbidities were documented.

Results
We reviewed the data of 115 patients, with a median follow-up from the start of PPRT of 28.7 months. Patients were treated with adjuvant intent (n = 23), for local recurrence (n = 27), or for a detectable PSA level (n = 65). The overall and cause-specific survival rate at 5 years was 73.7% and 81.4%, respectively. The biochemical disease-free survival rate was 69.6% at 2 years and 50% at 5 years. Factors predicting for subsequent relapse on multivariate analysis were pre-PPRT PSA (P = 0.013) and post-PPRT nadir (P <0.0001). Patients with a PSA greater than 1 ng/mL fared significantly worse than those with lower levels (P <0.0001). For patients with a pretreatment PSA of less than 1 ng/mL and an operative Gleason score of 7 or less, the 5-year projected biochemical disease-free survival rate was 71%. One case of grade 3 late proctitis was recorded, and 4 patients had continued grade 3 late urinary incontinence.

Conclusions
Early use of PPRT is effective and well tolerated in patients at risk of, or with proven, local recurrence.
Urology 61: 179–183, 2003. © 2003, Elsevier Science Inc.

Keyword Prostate specific antigen
Adjuvant radiation therapy
External beam irradiation
Radical prostatectomy
Cancer recurrence
Multivariate analysis
Postoperative radiotherapy
Surgical margin
Prediction
Antigen
Carcinoma
Tumoral marker
Prostatectomy
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown
Additional Notes Published under "Adult Urology"

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
 
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Created: Fri, 16 Apr 2010, 10:27:27 EST by Jon Swabey on behalf of Faculty Of Health Sciences