Efficacy of post-operative radiation in a prostatectomy cohort adjusted for clinical and genomic risk

A. E. Ross, R. B. Den, K. Yousefi, Bruce Trock, J. Tosoian, E. Davicioni, D. J S Thompson, V. Choeurng, Z. Haddad, Phuoc T Tran, E. J. Trabulsi, L. G. Gomella, C. D. Lallas, F. Abdollah, F. Y. Feng, E. A. Klein, A. P. Dicker, S. J. Freedland, R. J. Karnes, E. M. Schaeffer

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Abstract

Background:To date, there have been no published trials examining the impact of salvage radiation therapy (SRT) in the post-operative setting for prostate cancer (PCa). We conducted a retrospective, comparative study of post-operative radiation following radical prostatectomy (RP) for men with pT3 disease or positive margins (adverse pathological features, APF).Methods:422 PCa men treated at four institutions with RP and having APF were analyzed with a primary end point of metastasis. Adjuvant radiation treatment (ART, n=111), minimal residual disease (MRD) SRT (n=70) and SRT (n=83) were defined by PSA levels of -1, respectively, before radiation therapy (RT) initiation. Remaining 157 men who did not receive additional therapy before metastasis formed the no RT arm. Clinical–genomic risk was assessed by Cancer of the Prostate Risk Assessment Post-Surgical (CAPRA-S) and Decipher. Cox regression was used to evaluate the impact of treatment on outcome.Results:During the study follow-up, 37 men developed metastasis with a median follow-up of 8 years. Both CAPRA-S and Decipher had independent predictive value on multivariable analysis for metastasis (P

Original languageEnglish (US)
JournalProstate Cancer and Prostatic Diseases
DOIs
Publication statusAccepted/In press - May 3 2016

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ASJC Scopus subject areas

  • Oncology
  • Urology
  • Cancer Research

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