Salvage radiotherapy for men with isolated rising PSA or locally palpable recurrence after radical prostatectomy

Do outcomes differ?

O. Kenneth MacDonald, Steven E. Schild, Sujaya Vora, Paul E. Andrews, Robert G. Ferrigni, Donald E. Novicki, Scott K. Swanson, William W. Wong

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

To compare, in a retrospective analysis, the outcome of salvage external beam radiotherapy (EBRT) for isolated prostate-specific antigen (PSA) elevation or palpable local recurrence after radical prostatectomy (RP). We evaluated 102 men who underwent EBRT from 1993 to 1999, 60 for a rising PSA level alone and 42 for palpable local disease after RP. Biochemical disease-free survival and overall survival were calculated. Prognostic factors were evaluated to determine associations with biochemical disease-free survival. The 5-year rate of biochemical disease-free survival, local control, freedom from distant metastasis, and overall survival for all 102 patients was 38%, 94%, 87%, and 88%, respectively. All palpable disease resolved completely after salvage EBRT. The greatest 5-year rate of biochemical control (69%) was obtained in patients with a pre-EBRT PSA level of 0.5 ng/mL or less. The 5-year overall survival rate was significantly better for those who underwent salvage EBRT for a rising PSA level than for those with palpable recurrence (96% versus 78%, P = 0.02). A low pre-EBRT PSA level and a less than 2-year interval from RP to EBRT were independent predictors of biochemical failure. Five patients (5%) experienced chronic grade 3 or 4 RT-related toxicity. Salvage EBRT provides excellent local control of recurrent disease after RP. Salvage EBRT before the development of palpable local disease may confer a survival benefit and decrease the risk of metastasis, and durable biochemical control was achieved best in those whose pre-EBRT PSA level was 0.5 ng/mL or less. Early referral and careful patient selection is vital for salvage EBRT to be of optimal benefit.

Original languageEnglish (US)
Pages (from-to)760-764
Number of pages5
JournalUrology
Volume64
Issue number4
DOIs
StatePublished - Oct 2004

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Prostate-Specific Antigen
Prostatectomy
Radiotherapy
Recurrence
Disease-Free Survival
Survival
Neoplasm Metastasis
Patient Selection
Referral and Consultation
Survival Rate

ASJC Scopus subject areas

  • Urology

Cite this

MacDonald, O. K., Schild, S. E., Vora, S., Andrews, P. E., Ferrigni, R. G., Novicki, D. E., ... Wong, W. W. (2004). Salvage radiotherapy for men with isolated rising PSA or locally palpable recurrence after radical prostatectomy: Do outcomes differ? Urology, 64(4), 760-764. https://doi.org/10.1016/j.urology.2004.05.016

Salvage radiotherapy for men with isolated rising PSA or locally palpable recurrence after radical prostatectomy : Do outcomes differ? / MacDonald, O. Kenneth; Schild, Steven E.; Vora, Sujaya; Andrews, Paul E.; Ferrigni, Robert G.; Novicki, Donald E.; Swanson, Scott K.; Wong, William W.

In: Urology, Vol. 64, No. 4, 10.2004, p. 760-764.

Research output: Contribution to journalArticle

MacDonald, OK, Schild, SE, Vora, S, Andrews, PE, Ferrigni, RG, Novicki, DE, Swanson, SK & Wong, WW 2004, 'Salvage radiotherapy for men with isolated rising PSA or locally palpable recurrence after radical prostatectomy: Do outcomes differ?', Urology, vol. 64, no. 4, pp. 760-764. https://doi.org/10.1016/j.urology.2004.05.016
MacDonald, O. Kenneth ; Schild, Steven E. ; Vora, Sujaya ; Andrews, Paul E. ; Ferrigni, Robert G. ; Novicki, Donald E. ; Swanson, Scott K. ; Wong, William W. / Salvage radiotherapy for men with isolated rising PSA or locally palpable recurrence after radical prostatectomy : Do outcomes differ?. In: Urology. 2004 ; Vol. 64, No. 4. pp. 760-764.
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AU - Andrews, Paul E.

AU - Ferrigni, Robert G.

AU - Novicki, Donald E.

AU - Swanson, Scott K.

AU - Wong, William W.

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