Outcome of Adjuvant and Salvage Radiotherapy in Patients with Pathological T3 Disease or Positive Surgical Margin after Radical Prostatectomy

Abstract

Objective: To review the oncological outcome of the approaches of adjuvant radiotherapy and observation in patients with adverse pathologic findings (either pT3 or positive surgical margins) after radical prostatectomy (RP) Patients & Methods: Patients who received RP from January 2001 to July 2017 in our centre were retrospectively reviewed. Those with adverse pathologic findings, defined as either pT3 or positive surgical margins (PSM), were further analysed. Their oncological outcomes were evaluated. Results: 574 patients were included. 57 patients had pT3 disease and 118 had PSM. Seventeen (12.5%) received adjuvant radiotherapy (ART) whilst the rest opted for observation treatment. Of the observation group, 39 patients (32.77%) developed biochemical recurrence (BCR) and received salvage radiotherapy (SRT). In the ART group, the 5-year BCR-free survival was 82.4% and metastasis-free survival was 100%. Forthose who required SRTfor BCR, the 5-year BCR-free survival was 61.54% and metastasis-free survival was 87.18%. Conclusion: Although ART may be overtreatment for some patients with adverse pathologic results after radical prostatectomy, up to 41% of those in our cohort who opted for observation eventually required SRT for BCR.