Long-term Outcomes Following Radiation Therapy For Prostate Cancer Patients With Lymph Node Metastases at Diagnosis Treated With and Without Surgery. (April 2016)

• Record Type: Journal Article
• Authors: Crehange, Gilles; Izaguirre, Alejandra; Weinberg, Vivian; Hsu, Charles C.; Gottschalk, Alexander R.; Hsu, I-Chow; Shinohara, Katsuto; Carroll, Peter; Roach, Mack
• Is Part Of: American journal of clinical oncology. Volume 39:Number 2(2016)
• Publication Date: 2016-04
• Subjects: prostate cancer -- radiation therapy -- lymph node metastasis -- long-term outcome -- prognostic factors; Cancer -- Treatment -- Periodicals; Oncology -- Periodicals; Tumors -- Periodicals; 616.994005
• DOI: 10.1097/COC.0000000000000032
• Languages: English
• ISSNs: 0277-3732

Abstract

Abstract : Objectives: To evaluate the long-term outcomes for prostate cancer (PCa) patients with lymph node involvement (LNI) treated with radiotherapy at the University of California San Francisco. Materials and Methods: All newly diagnosed PCa patients with LNI treated with radiotherapy as primary therapy or after surgery, each with and without hormonal therapy (HT) between 1988 and 2009 were included. Thirty-five patients (38%) were managed with external beam radiotherapy alone (eRT), 18 patients (20%) with radical prostatectomy (RP)+adjuvant radiotherapy, and 38 patients (42%) with RP+salvage radiotherapy. Overall 82% of the study sample received HT with similar proportions among radiation therapy (RT) subsets ( P =0.83). Results: The median follow-up (FU) was 65, 42, and 86 months for patients treated with eRT, adjuvant radiotherapy, and salvage radiotherapy, respectively. The 10-year estimates from start of primary therapy for patients with LNI for overall survival (OS) was 78% (95% confidence interval [CI], 62%-88%) and for cause-specific survival was 89% (95% CI, 78%-95%). The 5-year estimates from the start of RT for biochemically no evidence of disease was 68% (95% CI, 56%-78%) and for disease-free survival was 67% (95% CI, 54%-77%). There was no difference in any of these outcomes among the 3 RT groups. Patients treated with HT were more likely to have a better 10-year OS (82% vs. 66%; log rank: P =0.001). Multivariate analysis indicated that only age and Gleason score were significant predictors for biochemically no evidence of disease and OS. Conclusions: Patients diagnosed with PCa with LNI who were treated with RT with or without a prior surgery had relatively favorable long-term outcomes.