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Adjuvant radiotherapy after radical prostatectomy shows no ability to improve rates of overall and cancer‐specific survival in a matched case‐control study
Author(s) -
Porter Christopher R.,
Capitanio Umberto,
Perrotte Paul,
Walz Jochen,
Isbarn Hendrik,
Kodama Koichi,
Gibbons Robert P.,
Correa Jr Roy,
Karakiewicz Pierre I.
Publication year - 2009
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2008.08133.x
Subject(s) - medicine , prostatectomy , prostate cancer , hazard ratio , log rank test , radiation therapy , urology , cohort , cancer , stage (stratigraphy) , survival analysis , proportional hazards model , oncology , surgery , confidence interval , paleontology , biology
OBJECTIVE To assess the effect of adjuvant radiotherapy (aRT) on the rate of cancer‐specific and overall survival after radical prostatectomy (RP) in a group of patients with a long‐term follow‐up, as there is controversy about the benefit of aRT after RP for prostate cancer when endpoints beyond biochemical and local recurrence are considered. PATIENTS AND METHODS Within a study cohort of 752 patients treated with RP, 118 (15.7%) received aRT; these patients were matched with controls who did not receive aRT after RP. Exact matches were made for pT stage, RP Gleason sum, surgical margin status, age (±10 years), year of surgery (±10 years) and delivery of hormonal therapy. Kaplan‐Meier and life‐table analyses were used to assess overall and cancer‐specific survival RESULTS The median (range) follow‐up was 11.4 (0.1–41) years. The 10‐ and 20‐year overall survival after RP in those with no aRT were, respectively, 81.1% and 44.8%, vs 75.5% and 40.0% in the aRT group ( P = 0.1). The corresponding probabilities for cause‐specific survival were, respectively, 97.3% and 89.0% vs 86.3% and 69.3% ( P < 0.001). There was no statistically significant difference in the overall and cause‐specific survival between the groups after matching (hazard ratio 0.9, log rank P = 0.6; and 2.1, log rank P = 0.1, respectively). CONCLUSIONS Our analysis showed that, in a matched case‐control study, aRT has no effect on overall and cancer‐specific survival. Further randomized long‐term studies are necessary to confirm these results.