The results of radical retropubic prostatectomy and adjuvant therapy for pathologic Stage C prostate cancer

Steven E. Schild, William W. Wong, Gordon L. Grado, Michele Y. Halyard, Donald E. Novicki, Scott K. Swanson, Thayne R. Larson, Robert G. Ferrigni

Research output: Contribution to journalArticle

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Abstract

Purpose: The results of therapy in 288 men with pathologic Stage C prostate cancer who underwent radical retropubic prostatectomy (RRP) were analyzed to determine the effects of adjuvant therapy. Methods and Materials: Twenty-seven of the 288 patients received preoperative neoadjuvant hormonal therapy (leuprolide acetate). Postoperatively, 60 patients received adjuvant radiotherapy (RT) to the prostate bed. Follow-up ranged from 3 to 83 months (median = 32 months). Freedom from failure (FFF) was defined as maintaining a serum PSA level of ≤ 0.3 ng/ml. Results: The FFF was 61% at 3 years and 45% at 5 years for the entire group. The FFF following RRP plus RT was 75% at 3 years and 57% at 5 years as compared to 56% at 3 years and 40% at 5 years for RRP without RT (p = 0.049). The FFF following RRP plus neoadjuvant hormonal therapy was 58% at 3 years and 40% at 5 years as compared to 60% at 3 years and 45% at 5 years following RRP without hormonal therapy (p = 0.3). In patients without seminal vesicle (SV) invasion, the FFF was 81% at 3 and 5 years for RRP plus RT as compared to 61% at 3 years and 50% at 5 years for RRP without RT (p = 0.01). In patients with SV invasion, the FFF was 61% at 3 years and 36% at 5 years for RRP plus RT as compared to 44% at 3 years and 23% at 5 years for RRP without RT (p = 0.23). The projected local control rate was 83% at 5 years for those with RRP alone as compared to 100% for RRP plus RT (p = 0.02). Survival at 5 years was projected to be 92% and was not significantly altered by the administration of adjuvant therapies. Conclusions: Postoperative RT was associated with significantly improved local control and FFF rates, especially in patients with tumors which did not involve the seminal vesicles.

Original languageEnglish (US)
Pages (from-to)535-541
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume34
Issue number3
DOIs
StatePublished - Feb 1 1996

Fingerprint

Prostatectomy
radiation therapy
therapy
Prostatic Neoplasms
cancer
Radiotherapy
Seminal Vesicles
Therapeutics
Neoadjuvant Therapy
Leuprolide
Adjuvant Radiotherapy
serums
beds
acetates
tumors
Prostate
Survival

Keywords

  • Hormonal therapy
  • Prostatectomy
  • Radiotherapy
  • Stage C prostate cancer

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

Cite this

The results of radical retropubic prostatectomy and adjuvant therapy for pathologic Stage C prostate cancer. / Schild, Steven E.; Wong, William W.; Grado, Gordon L.; Halyard, Michele Y.; Novicki, Donald E.; Swanson, Scott K.; Larson, Thayne R.; Ferrigni, Robert G.

In: International Journal of Radiation Oncology Biology Physics, Vol. 34, No. 3, 01.02.1996, p. 535-541.

Research output: Contribution to journalArticle

Schild, Steven E. ; Wong, William W. ; Grado, Gordon L. ; Halyard, Michele Y. ; Novicki, Donald E. ; Swanson, Scott K. ; Larson, Thayne R. ; Ferrigni, Robert G. / The results of radical retropubic prostatectomy and adjuvant therapy for pathologic Stage C prostate cancer. In: International Journal of Radiation Oncology Biology Physics. 1996 ; Vol. 34, No. 3. pp. 535-541.
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abstract = "Purpose: The results of therapy in 288 men with pathologic Stage C prostate cancer who underwent radical retropubic prostatectomy (RRP) were analyzed to determine the effects of adjuvant therapy. Methods and Materials: Twenty-seven of the 288 patients received preoperative neoadjuvant hormonal therapy (leuprolide acetate). Postoperatively, 60 patients received adjuvant radiotherapy (RT) to the prostate bed. Follow-up ranged from 3 to 83 months (median = 32 months). Freedom from failure (FFF) was defined as maintaining a serum PSA level of ≤ 0.3 ng/ml. Results: The FFF was 61{\%} at 3 years and 45{\%} at 5 years for the entire group. The FFF following RRP plus RT was 75{\%} at 3 years and 57{\%} at 5 years as compared to 56{\%} at 3 years and 40{\%} at 5 years for RRP without RT (p = 0.049). The FFF following RRP plus neoadjuvant hormonal therapy was 58{\%} at 3 years and 40{\%} at 5 years as compared to 60{\%} at 3 years and 45{\%} at 5 years following RRP without hormonal therapy (p = 0.3). In patients without seminal vesicle (SV) invasion, the FFF was 81{\%} at 3 and 5 years for RRP plus RT as compared to 61{\%} at 3 years and 50{\%} at 5 years for RRP without RT (p = 0.01). In patients with SV invasion, the FFF was 61{\%} at 3 years and 36{\%} at 5 years for RRP plus RT as compared to 44{\%} at 3 years and 23{\%} at 5 years for RRP without RT (p = 0.23). The projected local control rate was 83{\%} at 5 years for those with RRP alone as compared to 100{\%} for RRP plus RT (p = 0.02). Survival at 5 years was projected to be 92{\%} and was not significantly altered by the administration of adjuvant therapies. Conclusions: Postoperative RT was associated with significantly improved local control and FFF rates, especially in patients with tumors which did not involve the seminal vesicles.",
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AU - Novicki, Donald E.

AU - Swanson, Scott K.

AU - Larson, Thayne R.

AU - Ferrigni, Robert G.

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