Clinical Outcomes of Postoperative Radiotherapy Following Radical Prostatectomy in Patients with Localized Prostate Cancer: A Multicenter Retrospective Study (KROG 18-01) of a Korean Population
Cancer Research and Treatment 2020³â 52±Ç 1È£ p.167 ~ p.180
À̼º¿í(Lee Sung-Uk) - National Cancer Center Proton Therapy Center
Á¶°üÈ£(Cho Kwan-Ho) - National Cancer Center Proton Therapy Center
¹Ú¿ø(Park Won) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiation Oncology
Á¶¿ø°æ(Cho Won-Kyung) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiation Oncology
±èÀ缺(Kim Jae-Sung) - Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Radiation Oncology
À§Âù¿ì(Wee Chan-Woo) - Seoul National University College of Medicine Seoul National University Bundang Hospital Department of Radiation Oncology
±è¿µ¼®(Kim Young-Seok) - University of Ulsan College of Medicine Asan Medical Center Department of Radiation Oncology
±èÁøÈ£(Kim Jin-Ho) - Seoul National University College of Medicine Seoul National University Hospital Department of Radiation Oncology
³²ÅñÙ(Nam Taek-Keun) - Chonnam National University Medical School Chonnam National University Hwasun Hospital Department of Radiation Oncology
Á¶ÀçÈ£(Cho Jae-Ho) - Yonsei University College of Medicine Yonsei Cancer Center Department of Radiation Oncology
Á¤¼Û¹Ì(Jeong Song-Mi) - Ewha Womans University College of Medicine Ewha Womans University Medical Center Department of Radiation Oncology
±è¿µ°æ(Kim Young-Kyong) - Kyung Hee University College of Medicine Kyung Hee University Hospital Department of Radiation Oncology
½É¼öÁ¤(Shim Su-Jung) - Eulji University School of Medicine Eulji Hospital Department of Radiation Oncology
ÃÖ¿µ¹Î(Choi Young-Min) - Dong-A University College of Medicine Dong-A University Hospital Department of Radiation Oncology
±èÁØ»ó(Kim Jun-Sang) - Chungnam National University College of Medicine Department of Radiation Oncology
Abstract
Purpose: The purpose of this study was to investigate the clinical outcomes of postoperative radiotherapy (PORT) patients who underwent radical prostatectomy for localized prostate cancer.
Materials and Methods: Localized prostate cancer patients who received PORT after radical prostatectomy between 2001 and 2012 were identified retrospectively in a multi-institutional database. In total, 1,117 patients in 19 institutions were included. Biochemical failure after PORT was defined as prostate-specific antigen (PSA) ¡Ã nadir+2 after PORT or initiation of androgen deprivation therapy (ADT) for increasing PSA regardless of its value.
Results: Ten-year biochemical failure-free survival, clinical failure-free survival, distant metastasis-free survival, overall survival (OS), and cause-specific survival were 60.5%, 76.2%, 84.4%, 91.1%, and 96.6%, respectively, at a median of 84 months after PORT. Pre-PORT PSA ¡Â 0.5 ng/ml and Gleason¡¯s score ¡Â 7 predicted favorable clinical outcomes, with 10-year OS rates of 92.5% and 94.1%, respectively. The 10-year OS rate was 82.7% for patients with a PSA > 1.0 ng/mL and 86.0% for patients with a Gleason score of 8-10. The addition of long-term ADT (¡Ã 12 months) to PORT improved OS, particularly in those with a Gleason score of 8-10 or ¡Ã T3b.
Conclusion: Clinical outcomes of PORT in a Korean prostate cancer population were very similar to those in Western countries. Lower Gleason score and serum PSA level at the time of PORT were significantly associated with favorable outcomes. Addition of long-term ADT (¡Ã 12 months) to PORT should be considered, particularly in unfavorable risk patients with Gleason scores of 8-10 or ¡Ã T3b.
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Prostatic neoplasms, Prostatectomy, Radiotherapy, Prostate-specific antigen
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Ten-year biochemical failure-free survival, clinical failure-free survival, distant metastasis-free survival, overall survival (OS), and cause-specific survival were 60.5%, 76.2%, 84.4%, 91.1%, and 96.6%, respectively, at a median of 84 months after PORT; the clinical outcomes of PORT in a Korean population with prostate cancer were very similar to those published in Western countries. Gleason score and lower serum PSA level at the time of PORT were significantly associated with favorable outcomes in all clinical endpoints.