Adjuvant vs. salvage radiotherapy for patients at high risk for recurrence after radical prostatectomy

Abstract Prostate cancer patients with adverse pathologic factors (i.e., positive surgical margin, pT3 disease) after radical prostatectomy are more likely not cured (>60%) than cured by surgery alone. Adjuvant radiotherapy compared with observation reduces recurrence by 49% to 57%, may improve o...

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Bibliographic Details
Published in:Urologic oncology 2015-11, Vol.33 (11), p.451-455
Main Authors: Falchook, Aaron D., M.D, Chen, Ronald C., M.D., M.P.H
Format: Article
Language:English
Subjects:
Adjuvant radiotherapy
Prostate cancer
Radical prostatectomy
Urology
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Summary:Abstract Prostate cancer patients with adverse pathologic factors (i.e., positive surgical margin, pT3 disease) after radical prostatectomy are more likely not cured (>60%) than cured by surgery alone. Adjuvant radiotherapy compared with observation reduces recurrence by 49% to 57%, may improve overall survival, and improves long-term quality of life without increased long-term patient-reported urinary or gastrointestinal tract symptoms. Despite these results, adjuvant radiotherapy is uncommonly received by patients with these adverse factors. We discuss the rationale for adjuvant therapy as part of oncologic treatment and potential reasons why patients do not receive adjuvant radiotherapy in prostate cancer. We conclude that patients need a thorough discussion regarding the potential benefits and harms of both approaches (watch and wait vs. adjuvant radiotherapy) to make an informed decision.
ISSN:1078-1439
1873-2496
DOI:10.1016/j.urolonc.2015.07.021