Session Item

To analize clinical results of radiotherapy treatment after radical prostatectomy for prostate cancer and to determinate prognostic factors of biochemical relapse free survival (BRFS) and overall survival.   

We review the records of patients treated in our institution with postoperative radiotherapy (adjuvant and salvage radiotherapy indication according to international guidelines definition) after radical prostatectomy. Overall survival and biochemical-relapse free survival were analized using Kaplan-Meier and Cox regression analysis was used to assess differences between groups.

287 patients were treated at our institution over a 12-year period. Mean age at diagnosis was 64 years (41-75). All patients underwent radical prostatectomy combined with pelvic lymphadenectomy in 48.6% of cases. Neoadjuvant androgen deprivation before surgery was given to 35.6% . Median pre-RT PSA of 0.41ng/ml (0-12.8 ng/ml). Adjuvant RT (ART) was performed in 120 patients and salvage RT (SRT) in 168. Doses to surgical bed were ≥ 70 Gy (70-76 Gy) in 78.8% of patients and 66 Gy in 20.8%. The distribution of patients by pT stage was pT2a/b (29%), pT2c (37.1%), pT3 (28%) and pT4 (2.4%). Upgrade in Gleason Score between transrectal biopsy and prostatectomy was experienced by 46.7% of patients. Positive surgical margins were reported in 58.4% of cases. Mean follow-up was 146.7 months (10-289 months). Overall survival at 5 and 10 years was 97.1% and 85.5%, respectively and BRFS at 5 and 10 years was 83.4% vs. 79.9%, respectively.  No differences in BRFS between ART and SRT or doses to surgical bed were found.  Gleason score, T stage and PSA levels before RT were significant predictors of BRFS.    

Postoperative radiation therapy provides excellent long-term overall survival results with an aceptable BRFS. Lower PSA levels before radiotherapy is a predictor of better outcomes.  Early salvage and maderate doses are highly recommended.