In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 32, No. 4_suppl ( 2014-02-01), p. 30-30
Abstract:
30 Background: Although adjuvant radiotherapy (aRT) after radical prostatectomy (RP) improves biochemical recurrence (BCR)-free survival rates, its effect on cancer-specific mortality (CSM) in patients with prostate cancer (PCa) is still controversial. The aim of our study was to test the effect of aRT on CSM according to a risk score based on the number and nature of adverse pathological characteristics (Gleason score 8-10; pT3b/4, lymph node invasion [LNI]). Methods: Overall, 7,616 patients with pT3/4 N0/1 PCa treated with RP between 1995 and 2009 within the Surveillance Epidemiology and End Results Medicare-linked database were included in the study. Patients were stratified according to the risk score (less than 2 vs. 2 or more adverse characteristics), and the impact of aRT on CSM was examined in each sub-group. Additionally, to evaluate the effectiveness of aRT, we calculated the number needed to treat (NNT), defined as the average number of patients who must be treated to prevent one detrimental outcome. Subsequently, competing-risks regression models were used to test the effect of aRT on CSM rates in the overall population and after stratifying patients according to their risk score (less than 2 vs. 2 or more). Results: The risk score was associated with increasing 10-year CSM rates (P 〈 0.001). When focusing on patients with a risk score 2 or more, 10-year CSM rates were significantly lower for individuals undergoing aRT compared to their counterpart not receiving aRT (6.9 vs. 16.2%, respectively; P=0.002). The corresponding NNT to prevent one death from PCa was 10. Adjuvant RT was not associated with lower CSM rates overall and in patients with a risk score less than 2. This was confirmed in multivariable analyses, where aRT decreased the risk of CSM only in patients with a risk score 2 or more (P≤0.02). Conclusions: Our findings confirm the validity of the previously reported risk score in selecting the most optimal candidates for aRT after surgery in a large contemporary population-based cohort of patients with pT3/4 N0/1 PCa. Patients with two or more adverse pathological characteristics at RP might benefit the most from aRT in terms of reduced CSM.
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/jco.2014.32.4_suppl.30
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2014
detail.hit.zdb_id:
2005181-5
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