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

Sung Uk Lee, Kwan Ho Cho, Won Park, Won Kyung Cho, Jae Sung Kim, Chan Woo Wee, Young Seok Kim, Jin Ho Kim, Taek Keun Nam, Jaeho Cho, Song Mi Jeong, Youngkyong Kim, Su Jung Shim, Youngmin Choi, Jun Sang Kim

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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) ≥ 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 " 0.5 ng/ml and Gleason’s score " 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 (≥ 12 months) to PORT improved OS, particularly in those with a Gleason score of 8-10 or ≥ 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 (≥ 12 months) to PORT should be considered, particularly in unfavorable risk patients with Gleason scores of 8-10 or ≥ T3b.

Original languageEnglish
Pages (from-to)167-180
Number of pages14
JournalCancer Research and Treatment
Volume52
Issue number1
DOIs
Publication statusPublished - 2020 Jan 1

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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    Lee, S. U., Cho, K. H., Park, W., Cho, W. K., Kim, J. S., Wee, C. W., Kim, Y. S., Kim, J. H., Nam, T. K., Cho, J., Jeong, S. M., Kim, Y., Shim, S. J., Choi, Y., & Kim, J. S. (2020). 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, 52(1), 167-180. https://doi.org/10.4143/crt.2019.126