Adjuvant Radiation Therapy After Radical Prostatectomy

(Prepared by Cecilia Lacks, PhD, from AUA presentation by William J. Catalona, MD and his Research Collaborators)

INTRO: New studies are demonstrating that adjuvant radiation therapy improves PSA progression-free survival in men with adverse pathology in their surgical specimen. Adjuvant radiotherapy is given as a precautionary measure in patients who have adverse features in their pathology report. This radiotherapy is usually given 3 to 4 months after the operation when urinary continence has returned. It may be delayed further if continence has not yet returned.

QUESTION: What does our data show about the effect of adjuvant radiation therapy after a RRP?

STUDY: Between 1985 and 2005, 213 men underwent radical prostatectomy and received adjuvant radiation therapy. We divided these men into two groups: a. 137 men with positive margins or extracapsular extension only and b. 76 men with seminal vesicle invasion or lymph node metastases.

CONCLUSION: More than half of patients with adverse pathology on their radical prostatectomy specimen have long-term, progression-free survival with excellent cancer-specific survival. Less favorable results are achieved in men with seminal vesicle invasion or lymph node metastases.
Further study is needed to compare the outcomes of adjuvant radiotherapy with early salvage therapy.