NEW YORK (Reuters Health) Feb 16 - Adjuvant radiotherapy can cut the risk of metastasis and improve survival in men who have undergone radical prostatectomy for pathological T3N0M0 prostate cancer, according to a report in the March issue of The Journal of Urology.
Prior research has shown that roughly a third of men who undergo radical prostatectomy for apparently localized prostate cancer will develop extraprostatic disease. Whether adjuvant radiotherapy may help cut risk of metastatic disease and mortality was unclear.
Dr. Ian M. Thompson, from the University of Texas Health Science Center, San Antonio, and colleagues addressed this topic by assessing the outcomes of 431 men who were randomized to receive adjuvant radiotherapy (60 to 64 Gy) or observation after radical prostatectomy. Seventy of the 211 men randomized to observation later received radiotherapy.
Radiotherapy increased the odds of metastasis-free survival and overall survival. Specifically, the hazard ratio for metastasis in the radiotherapy arm versus the observation arm was 0.71 (p = 0.016), and the corresponding mortality hazard ratio was 0.72 (p = 0.023).
The investigators conclude that "adjuvant radiotherapy within 18 weeks after radical prostatectomy in a man with T3N0M0 prostate cancer significantly reduces the risk of PSA recurrence, metastasis, and the need for hormonal therapy, and significantly increases survival."
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