Randomised Trial of Adjuvant Radiotherapy Following Radical Prostatectomy Versus Radical Prostatectomy Alone in Prostate Cancer Patients with Positive Margins or Extracapsular Extension

Show full item record

Permalink

http://hdl.handle.net/10138/306830

Citation

FinnProstate Grp , Hackman , G , Taari , K , Tammela , T L , Matikainen , M , Kouri , M , Joensuu , T , Luukkaala , T , Salonen , A , Isotalo , T , Petas , A , Hendolin , N , Boström , P J , Aaltomaa , S , Lehtoranta , K , Hellström , P , Riikonen , J , Korpela , M , Minn , H , Kellokumpu-Lehtinen , P-L , Pukkala , E & Hemminki , A 2019 , ' Randomised Trial of Adjuvant Radiotherapy Following Radical Prostatectomy Versus Radical Prostatectomy Alone in Prostate Cancer Patients with Positive Margins or Extracapsular Extension ' , European Urology , vol. 76 , no. 5 , pp. 586-595 . https://doi.org/10.1016/j.eururo.2019.07.001

Title: Randomised Trial of Adjuvant Radiotherapy Following Radical Prostatectomy Versus Radical Prostatectomy Alone in Prostate Cancer Patients with Positive Margins or Extracapsular Extension
Author: FinnProstate Grp; Hackman, Greetta; Taari, Kimmo; Tammela, Teuvo L.; Matikainen, Mika; Kouri, Mauri; Joensuu, Timo; Luukkaala, Tiina; Salonen, Arto; Isotalo, Taina; Petas, Anssi; Hendolin, Niilo; Boström, Peter J.; Aaltomaa, Sirpa; Lehtoranta, Kari; Hellström, Pekka; Riikonen, Jarno; Korpela, Merja; Minn, Heikki; Kellokumpu-Lehtinen, Pirkko-Liisa; Pukkala, Eero; Hemminki, Akseli
Contributor: University of Helsinki, HUS Abdominal Center
University of Helsinki, HUS Abdominal Center
University of Helsinki, HUS Comprehensive Cancer Center
University of Helsinki, HUS Comprehensive Cancer Center
University of Helsinki, HYKS erva
University of Helsinki, HUS Abdominal Center
University of Helsinki, Päijät-Häme Welfare Consortium
University of Helsinki, Department of Oncology
Date: 2019-11
Number of pages: 10
Belongs to series: European Urology
ISSN: 0302-2838
URI: http://hdl.handle.net/10138/306830
Abstract: Background: It remains unclear whether patients with positive surgical margins or extracapsular extension benefit from adjuvant radiotherapy following radical prostatectomy. Objective: To compare the effectiveness and tolerability of adjuvant radiotherapy following radical prostatectomy. Design, setting, and participants: This was a randomised, open-label, parallel-group trial. A total of 250 patients were enrolled between April 2004 and October 2012 in eight Finnish hospitals, with pT2 with positive margins or pT3a, pN0, M0 cancer without seminal vesicle invasion. Intervention: A total of 126 patients received adjuvant radiotherapy at 66.6 Gy. Outcome measurements and statistical analysis: The primary endpoint was biochemical recurrence-free survival, which we analysed using the Kaplan-Meier method and Cox proportional hazard regression. Overall survival, cancer-specific survival, local recurrence, and adverse events were secondary endpoints. Results and limitations: The median follow-up time for patients who were alive when the follow-up ended was 9.3 yr in the adjuvant group and 8.6 yr in the observation group. The 10-yr survival for biochemical recurrence was 82% in the adjuvant group and 61% in the observation group (hazard ratio [HR] 0.26 [95% confidence interval {CI} 0.14-0.48], p <0.001), and for overall survival 92% and 87%, respectively (HR 0.69 [95% CI 0.29-1.60], p = 0.4). Two and four metastatic cancers occurred, respectively. Out of the 43 patients with biochemical recurrence in the observation group, 37 patients received salvage radiotherapy. In the adjuvant group, 56% experienced grade 3 adverse events, versus 40% in the observation group (p = 0.016). Only one grade 4 adverse event occurred (adjuvant group). A limitation of this study was the number of patients. Conclusions: Adjuvant radiotherapy following radical prostatectomy is generally well tolerated and prolongs biochemical recurrence-free survival compared with radical prostatectomy alone in patients with positive margins or extracapsular extension. Patient summary: Radiotherapy given immediately after prostate cancer surgery prolongs prostate-specific antigen progression-free survival, but causes more adverse events, when compared with surgery alone. (C) 2019 European Association of Urology. Published by Elsevier B.V. All rights reserved.
Subject: Adjuvant radiotherapy
Extracapsular extension
Prostate cancer
Positive margins
Radical prostatectomy
SALVAGE RADIATION-THERAPY
SEMINAL-VESICLE INVASION
BIOCHEMICAL RECURRENCE
OUTCOMES
ADENOCARCINOMA
SURVIVAL
PREDICT
RATES
RISK
PT3B
3126 Surgery, anesthesiology, intensive care, radiology
3122 Cancers
Rights:


Files in this item

Total number of downloads: Loading...

Files Size Format View
1_s2.0_S0302283819305251_main.pdf 2.081Mb PDF View/Open

This item appears in the following Collection(s)

Show full item record